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The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24 h after the surgical procedure with the device off. G2 followed the same time pattern, 24 h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30 min, using 660 nm (red), energy 180 J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21 days. The revaluation was performed after 7 and 21 days. The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety. The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24 h after the procedure proved to be more advantageous., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Objectives: Dentin hypersensitivity (DH) affects patients' oral health-related quality of life, but is not always optimally treated in dental offices. The objectives were to assess dentists' DH-related education, knowledge, and professional behavior and explore relationships between education, knowledge, and behavior., Methods: Survey data were collected from 220 ADA members in the United States. Descriptive and correlational analyses were performed., Results: About half of the respondents agreed/strongly agreed that their dental school had educated them well about diagnosing DH in classroom-based (53.6%) and clinical settings (48.9%). Lower percentages agreed being well educated about treating DH (40.9%/37.3%). The majority self-educated themselves about DH after dental school by attending continuing education courses in person or online (60.6%/36.8%), reading articles (64.1%), or consulting with colleagues (59.6%). The majority knew that patients with DH describe their pain as stimulated (91.4%) and that recessed gingiva (89.6%), abrasion lesions (72.3%), tooth whitening (63.1%), erosion lesions (58.6%), and abfraction lesions (51.4%) are risk factors for DH. The majority diagnosed DH with patient self-reporting, confirmed by exams (81.8%), applying air blasts (53.7%), or cold-water (52.3%). They treated patients with DH often/very often with over-the-counter desensitizing agents (90%), and prescribing fluoride formulations toothpaste (82.8%) and/or potassium nitrate toothpastes (60.9%). In their offices, the majority (73.2%) educated their patients often/very often about DH and used fluoride dental varnish for treating DH (71.8%). The more recently respondents had graduated from dental school, the more positively they described their dental school education (r = 0.14; p < 0.05), the more ways to diagnose DH they used (r = 0.16; p < 0.05) and the more often they used fluoride dental varnish in their offices (r = 0.23; p < 0.001). The more dentists had educated themselves, the more methods for diagnosing DH they used (r = 0.23; p < 0.001) and the more often they used potassium oxalate products (r = 0.19; p < 0.01), Arginine/calcium products (r = 0.19; p < 0.01) and dentin bonding (r = 0.22; p < 0.001)., Conclusions: More recently graduating from dental school correlates with more positive evaluations of DH-related dental school education. The finding that most dentists engage in self-education about DH after dental school should motivate dental educators to increase education about this topic not only in dental school, but also in continuing education courses., (© 2023 The Authors. Journal of Dental Education published by Wiley Periodicals LLC on behalf of American Dental Education Association.)

This study evaluated the effects of laser application of diverse wavelengths applied simultaneously and on different skins. The sample included two participants, a woman with light skin with abdominal hair and a woman with dark skin and hair on the inner part of the lower limbs, who received a laser therapy session. After 45 days from laser application, abdominoplasty and thigh dermolipectomy surgery were performed. In the control sample, the hair follicles were in the anagen phase, showing the presence of Bcl-2 expression. In the treated areas, follicles were observed in an advanced phase (telogen), with the presence of CK-18 and negativity of Bcl-2, highlighting the phase of hair loss at that moment and the complete apoptosis of the investigated follicle. Significant difference was observed in the comparison of the anagen phase ( p  = .00) and it similarly occurred in the comparison of the telogen phase ( p  = .00). The presence of a greater amount of follicles in the anagen phase in the control area and follicles in the telogen phase in the treated area demonstrates the efficiency of the laser at different wavelengths when reaching different skin phototypes and hair thickness, being reinforced by apoptosis and cell proliferation markers. Therefore, the hair-removal process has been optimized with various laser wavelengths.

Objectives: To evaluate Microablative Fractional Radiofrequency (MAFRF) as a possible option in treating vaginal atrophy., Methods: This was a randomized, controlled clinical trial with postmenopausal women diagnosed with vaginal atrophy. The treatment consisted of three sessions of MAFRF, compared to vaginal estrogen administration and an untreated control group. Assessments occurred at baseline and 90 days. The primary endpoints were sexual function, evaluated by the Female Sexual Function Index (FSFI), and vaginal health, assessed by the Vaginal Health Index (VHI). Secondary outcomes included vaginal microbiota composition (Nugent score) and epithelial cell maturation (Maturation Value ‒ MV)., Results: One hundred and twenty women (40 in each group) were included. Concerning the FSFI, both groups, MAFRF (median 4.8 [3.6‒6.0]) and vaginal estrogen (mean 4.7 ± 1.1), experienced improved sexual desire when compared to the control group (median 3.6 [2.4‒4.8]). Regarding the total score of VHI, the authors observed an improvement in the mean of the MAFRF (23.7 ± 2.0) and vaginal estrogen groups (23.5 ± 1.9) when compared to the control (14.8 ± 2.9). The Nugent score was reduced in the MAFRF and estrogen groups (p < 0.01) compared to the control group. Lastly, the MV was modified after treatment with MAFRF (p < 0.01) and vaginal estrogen (p < 0.001). No differences existed between the MAFRF and vaginal estrogen groups in the studied variables. No adverse effects were reported following the MAFRF protocol., Conclusions: Radiofrequency was comparable in efficacy to estrogen administration for treating vulvovaginal atrophy. It deserves consideration as a viable option in managing this condition., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: This study analyzed the histological and immunohistochemical changes in hair follicles submitted to epilation with light-emitting diode (LED). Background: The use of specific wavelengths of LED leads to the absorption of photons by chromophore tissues, enabling different photophysical and photochemical events, bringing therapeutic benefits such as removing body hair. Methods: The sample included five participants, with phototypes II-V, divided into two groups. The volunteers received a session of epilation with the Holonyak ® device on the pubic region and right groin, whereas the contralateral side was kept as a control. An energy of 10 J and a cooling temperature of -5°C were used, after which the pain provoked by the equipment was questioned using the analogue pain scale. After 45 days, the punching procedure was performed in the region where skin samples were taken for histological and immunohistochemical analysis. Results: For all phototypes, in the treated area, the follicles and sebaceous glands were in a stage of involution, showing perifollicular inflammatory infiltrate with changes suggestive of apoptosis. The apoptosis process was confirmed by the increase in markers cytokeratin-18 and cleaved caspase 3, in addition to the reduced expression of Blc-2, and the lower cell proliferation (Ki67), reinforcing the action of LED based on the definite involution and resorption of the follicle, through macrophages (CD68) triggered by the inflammatory process. Conclusions: The preliminary results of this study found relevant histological changes and immunohistochemical markers in the epilation process, which may indicate the efficacy of LED in permanent hair removal.

Background: High-intensity stationary therapeutic ultrasound (HITU) technology is gaining popularity as an attractive modality for treating different conditions, but little is known about its application in aesthetics., Objective: To analyze the effects of stationary unfocused ultrasound (HITU technology) in treating localized fat in women's abdominal region., Methods: The sample consisted of 43 women with localized abdominal adiposity, assessed pre and post-treatment by assessment protocols, adversity analysis questionnaires, ultrasound exams, and serum level exams. The volunteers were randomly divided into three subgroups: G-1, who used the device off, G-2 received therapy with the device once a week for two months (Parameters: Pulsed - 100Hz - 50% - 4.0 W/cm 2 - 20 minutes) and the G-3 who used the device on twice a week for a month (Parameters: Pulsed - 100Hz - 50% - 3.2W/cm 2 - 30 minutes). All groups received eight sessions in total., Results: There was a significant reduction for G-3 in the plicometry of the lower right region ( p =0.01) in the comparison between the final and initial moments. In the comparison among the three research groups, there was a significant reduction in plicometry in the lower right ( p =0.03) and left ( p =0.02) regions in G3. Via ultrasound, a reduction in the fat layers average was observed in all groups. In G-3, there were significant differences in the left infraumbilical region ( p =0.02) and right ( p =0.04). In the group comparison, the right infraumbilical region showed significant differences ( p =0.04) for the G-3. No differences were found for weight, BMI, body fat percentage and supra, infra and umbilical perimetry ( p >0.05). The adverse reactions reported were: Mild hyperaemia (75%) and sensation of shock (21%), there were also reports of improvement in fluid retention in 93.7 percent of the volunteers, and most were satisfied with the result., Conclusion: Both treatment protocols for the reduction of localized adiposity were effective compared to the placebo group, with a significant reduction in the use of ultrasound and plicometry in the concentration of fat in the lower abdominal region., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2023. Matrix Medical Communications. All rights reserved.)

Objectives: The authors aimed to evaluate clinical and histological changes induced by Fractional Radiofrequency (FRF) and microneedling in vulvar tissue., Methods: Thirty postmenopausal women were randomly divided into G1 (FRF) and G2 (microneedling) groups. Sub-ablative FRF was executed using disposable fractionated electrodes with an intensity of 8 mJ. Microneedling was performed using a derma roller system. The authors evaluated before and after treatment using the Vaginal Laxity Questionnaire (VLQ), EuroQol Five-Dimensional (EQ-5D) questionnaire, and the Blatt and Kupperman Menopausal Index (BKMI). Additionally, the authors performed biopsies of the labia majora for histological analysis pre- and post-treatment. Data were expressed as mean (± standard deviation). A paired t-test was used for intra-group comparison (pre- and post-treatment), with an independent t-test used to compare intergroup data (both pre- and post-treatment)., Results: In the G1 group, the VLQ values showed differences compared to the pre-treatment values with the data obtained 60 days after the beginning of the sessions (p = 0.01). Similarly, the data changes of the G2 group proved to be significant (p = 0.001) across the same time interval. In comparing the groups, VLQ values were not different (p > 0.05). Regarding histological analysis, FRF demonstrated improvement concerning the number of fibroblasts, blood vessels, and fatty degeneration (p < 0.05) compared to the control. Additionally, FRF and microneedling samples showed higher type III collagen and vimentin expression in the immunohistochemical analysis (p < 0.05)., Conclusions: The therapies were found to be effective in treating the flaccidity of the female external genitalia. Additionally, histological changes were observed after interventions suggesting collagen remodeling., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Microneedling promotes skin microlesions that lead to an inflammatory process, increasing cell proliferation, cell metabolism, and synthesis of collagen and elastin, therefore restoring skin integrity., Objective: This study aims to investigate the differences between the physical and the physical-chemical sunscreen application after microneedling, assessed through histological analysis., Method: This was a two-phase study. The first phase investigated the physical and physical-chemical sunscreen penetration mixed with India ink through histological analysis. The sunscreens were applied after the microleakage in vivo on the skin of a volunteer who underwent abdominoplasty 24 hours after the procedure. Histological analyses were carried out using optical and electron microscopy. The second phase analysed the skin reactions with the use of physical sunscreen after different microneedling treatments. The sample consisted of 30 volunteers distributed into three groups: G1 received the "Roller" microneedling, G2 received pen micropuncture treatment, and G3 received the fractional radiofrequency treatment., Results: The histological analyses of the first phase indicated that the physical-chemical protection sunscreen penetrated more deeply, and pigment was found among the collagen fibres and the dermal fibroblast cytoplasm in comparison to the physical protection sunscreen, which had the pigment confined exclusively in the superficial epidermis layer. The second phase results demonstrated that the use of the physical protection sunscreen after the different microneedling techniques showed no adverse reactions such as itching, pain or soreness, and the hyperaemia., Conclusion: The proposed intervention showed that the use of physical protection sunscreen after different microneedling procedures is safe., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

BACKGROUND: Cryofrequency combines cryotherapy with radiofrequency, reaching the tissue in different layers, providing various biological effects, and reducing localized adiposity. OBJECTIVE: We sought to evaluate the efficacy of cryofrequency in reducing localized adiposity. METHODS: The study population consisted of 63 women with infra-abdominal adiposity, evaluated before and after treatment using evaluation protocols, questionnaires, and ultrasound imaging. The volunteers were randomly distributed into three subgroups; of these, Group 1 (G01) received the cryofrequency treatment (temperature of -10°C, 85% power); Group 2 (G02) underwent cryofrequency associated with ultracavitation (frequency of 60 Hz, 70% power, shooting at 25%, duty cycle of 60% on and 40% off); and the control group (CG) received cryotherapy alone (temperature of -10°C). All groups were submitted to four treatment sessions, one session per week. RESULTS: The reduction in the fat layer analyzed by ultrasonography showed that the right side of G01 presented a significant difference in comparison with CG ( p =0.01); a significant difference was also observed in the comparison between the G01 and G02 groups ( p =0.001). Considering the left side, significant differences were observed in G01 when compared with CG ( p =0.01) and between G01 and G02 ( p =0.001). The variables of plicometry and perimetry presented a significant difference relative to in CG; however, no differences were observed with regard to weight or body mass index ( p >0.05). The majority of participants reported positive feelings about the treatment. CONCLUSIONS: The cryofrequency protocol alone led to a significant reduction in the fat layer but its association with ultracavitation led to superior results., Competing Interests: FUNDING:No funding was provided for this study. DISCLOSURES:The authors have no conflicts of interest relevant to the content of this article., (Copyright © 2020. Matrix Medical Communications. All rights reserved.)

Objective: Laboratory tests are routinely used to test bonding properties of dental adhesives. Various aging methods that simulate the oral environment are used to complement these tests for assessment of adhesive bond durability. However, most of these methods challenge hydrolytic and mechanical stability of the adhesive- enamel/dentin interface, and not the biostability of dental adhesives. To compare resin-dentin microtensile bond strength (μTBS) after a 15-day Streptococcus mutans (SM) or Streptococcus sobrinus (SS) bacterial exposure to the 6-month water storage (WS) ISO 11405 type 3 test., Methodology: A total of 31 molars were flattened and their exposed dentin was restored with Optibond-FL adhesive system and Z-100 dental composite. Each restored molar was sectioned and trimmed into four dumbbell-shaped specimens, and randomly distributed based on the following aging conditions: A) 6 months of WS (n=31), B) 5.5 months of WS + 15 days of a SM-biofilm challenge (n=31), C) 15 days of a SM-biofilm challenge (n=31) and D) 15 days of a SS-biofilm challenge (n=31). μTBS were determined and the failure modes were classified using light microscopy., Results: Statistical analyses showed that each type of aging condition affected μTBS (p<0.0001). For Group A (49.7±15.5MPa), the mean μTBS was significantly greater than in Groups B (19.3±6.3MPa), C (19.9±5.9MPa) and D (23.6±7.9MPa). For Group D, the mean μTBS was also significantly greater than for Groups B and C, but no difference was observed between Groups B and C., Conclusion: A Streptococcus mutans- or Streptococcus sobrinus-based biofilm challenge for 15 days resulted in a significantly lower μTBS than did the ISO 11405 recommended 6 months of water storage. This type of biofilm-based aging model seems to be a practical method for testing biostability of resin-dentin bonding.

Objective: To compare the color of double-layered (DL) resin-composite (RC) samples with variant enamel-thicknesses (ET) to their corresponding shade-tabs from VITA classical (VC) and 3D-Master (V3DM)., Methods: A2-DL samples (N = 30) fabricated using three pairs of custom-made molds with an ET of 0.5, 0.7, and 1.0 mm. Shades were selected according to the manufacturer's instructions of two RC brands: Clearfil-Majesty (CM), and Vita-l-essence (VL). A spectrophotometer measured CIE L*a*b* color parameters. We used ΔE 00 to calculate color differences among DL samples, VC, and V3DM shade-tabs. The data were analyzed using Spearman correlation coefficient, one-way ANOVA, and Tukey test (∝=0.05)., Results: ΔE 00 between DL samples A2 and 2M2 shade tabs were all greater than the predetermined 50:50% acceptability threshold (ΔE 00 = 6.6-10.4). Depending on the shade tabs compared, the ΔE 00 among CM and VL ET subgroups were statistically different (P < .001). ET and L* were negatively correlated for CM and VL. For CM, ΔE 00 and L* correlated on the A2 shade tab, whereas for VL, ΔE 00 , and ET correlated on the 2M2 shade tab (P < .05)., Conclusions: The DL samples produced unacceptable color matches to their corresponding shade. An enamel layer thickness of 0.7 mm corresponded to the lowest ΔE 00 . The use of V3DM for RC shade selection should be investigated., Clinical Significance: Understanding color interaction between RC layers is important to achieve consistent results in esthetic clinical procedures. The thickness of the enamel layer can critically alter the overall shade for a given RC shade and brand. This variation is difficult for the clinician to predict and negatively impacts patient satisfaction, increasing overall procedure costs, and decreasing efficiency. This color interaction study aims to facilitate consistency in shade reproduction., (© 2019 Wiley Periodicals, Inc.)

Purpose: The purpose of the present in vitro study and survey was to compare the masking ability and the penetration capacity of three resin composite sealers as well as a resin infiltrant in shallow artificial caries lesions., Materials and Methods: Panels of artificial initial caries lesion with an average depth of 200 µm were created on buccal and lingual surfaces of 75 extracted human molars. Specimens were randomly assigned to 5 groups: ICON (DMG America), Biscover LV (Bisco), Optiguard (Kerr Hawe), Permaseal (Ultradent), and control (no treatment). Teeth were hemi-sectioned yielding two halves, each with a panel of artificial caries lesion. Lesions on one hemi-section were used to assess the esthetic improvement following caries lesion penetration with the 4 resins based on photographs evaluated using a 100-mm visual analogue scale (VAS) by 17 raters. Lesions on opposite hemi-sections were used to measure the resin penetration area percentage (PA%) and the resin penetration depth percentage (PD%) visualized using a confocal laser scanning microscope (CLSM, Leica)., Results: ICON, Optiguard, and Permaseal yielded significantly greater average VAS scores compared to Biscover. The mean PA% and PD% were significantly higher for ICON, intermediate for Optibond and Permaseal, and significantly lower for Biscover. A moderately large positive correlation was noticed between the average VAS scores and the penetration measures., Conclusion: All the resin sealers (Biscover, Optiguard, and Permaseal) penetrated the artificial initial caries lesions. However, ICON resulted in the deepest penetration and the largest penetration area percentages. The masking ability of Optiguard and Permaseal of the artificial caries lesions was similar to ICON.

Objective: This study used three LASERs (red, green, and blue) with a spectrophotometer to compare the light propagation for the following: absorption (A), transmittance (T), attenuation (K), and scattering anisotropy coefficient (g) in dental tissues and nano-filled resin-based composites. This study used three distinct incremental build-up techniques, which included one shade (body), two shades (enamel and dentin), and three shades (enamel, transparent, and dentin)., Methods: Twenty human, un-erupted, recently extracted third molars (shade B1) were used to obtain 40 tooth slabs. The samples were randomized and equally distributed into four experimental groups. The Positive Control Group included dental tissues with enamel, dento-enamel junction DEJ, and dentin; the Technique 1 group (T1) included one shade tissues, B1B; the Technique 2 group (T2) included two-shades tissues, A2Dentin and B1Enamel; and the Technique 3 group (T3) included three shade tissues, A2Dentin, Transparent, and B1Enamel. Cavity preparation was standardized, and, using the spectrophotometer, each specimen was irradiated by three LASERs. A voltmeter recorded the light-output signal, and from this raw data, the following optical constants (A, T, K, g) were calculated., Results: ANOVA, followed by a post hoc Tukey's test (p < 0.05), revealed that absorption and transmittance in dental tissues were significantly different when comparing the three build-up technique groups. However, when examining attenuation coefficient, there was no significant difference in dental tissues for T2 and T3 as analyzed by blue and red lasers. There was also no significant difference among the three lasers for T2 and T3. There was also no significant effect of the types of experiments on the value of scattering anisotropy factor g for blue laser among the four experimental groups., Conclusion: Within the limitations of this study, none of the build-up techniques were able to reproduce the dental tissues optical properties, and T2 and T3 resulted in a similar pattern of light propagation., Clinical Significance: The clinical success of restorative procedures depends on selecting materials and techniques that emulate the natural tooth and provide long-term stability in color and optical properties.

Purpose: To evaluate and compare light propagation in dental tissues and dental composite restorations using a double-layer build-up technique., Materials and Methods: Natural teeth slabs and dental restoration buildups with A2D and B1E-colored nanofilled, supra-nanofilled, and microhybrid composites were randomized and equally distributed into four experimental groups (n = 10). Using a spectrophotometer, the samples were irradiated by three wavelengths of lasers: red, green, and blue. A voltmeter recorded the light output signal, and the following optical constants were calculated: absorption (A), transmittance (T), and attenuation (K). The data were analyzed using one-way analysis of variance (ANOVA), followed by post hoc Tukey's test (α = 0.05)., Results: Absorption results varied according to the laser color and different composites tested. Regardless of the laser wavelength, the supra-nanofilled composite showed greater light transmittance and lower light attenuation compared with the dental tissues, which was the opposite of the nanofilled composite. The microhybrid composite showed no difference in light transmittance or light attenuation compared with the dental tissues., Conclusion: Within the limitations of this observational in vitro study, the microhybrid dental composite group had the most similar light propagation pattern compared with natural teeth when using the double-layer build-up technique.

In the direct-indirect composite technique, composite is applied to a nonretentive tooth preparation (eg, a noncarious cervical lesion or a veneer/inlay/onlay preparation) without any bonding agent, sculpted to a primary anatomic form, and light-cured. The partially polymerized restoration is then removed from the preparation and finished and tempered extraorally chairside. The finished inlay is bonded to the preparation using a resin-based luting agent. Advantages of this technique include enhanced physical and mechanical properties afforded by the extraoral chairside tempering process because of increased monomer conversion, and greater operator control over the final marginal adaptation, surface finishing and polishing, and anatomy of the restoration, given that these elements are defined outside of the patient's mouth. The direct-indirect approach also affords enhanced gingival health and patient comfort. This article presents a clinical case in which the direct-indirect composite technique was used to restore three noncarious cervical lesions on the same quadrant on an adult patient. Clinical steps and tips for success are offered. The authors also present scanning electron microscope and atomic force microscope images showing the excellent marginal fit obtained with the direct-indirect composite technique.

This clinical report describes a conservative treatment in veneer replacement where diastemas, malalignment, and midline shift were the main modifying factors. When replacement veneers are indicated, the definitive results can only be accurately predicted after an esthetic reanalysis of the existing restorations., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The use of direct composite resin for diastema closure has technique advantages, including that the restorative procedure can be carried out in one appointment at a reasonable cost and without the removal of sound tooth structure. The use of a rubber dam for closing diastemas with composite resin is of paramount importance as it prevents moisture contamination and ensures increased gingival retraction compared to other techniques. This provides better access to the cervical area of the tooth, facilitating proper placement of resin to recreate the natural anatomical contours and contact point. Thus, there is a more natural adaptation of the restoration to the gingival tissue, avoiding a space between the papilla and the restored tooth. To illustrate the advantages of this technique, two diastema closure cases are presented using direct composite resin with rubber dam isolation.

Purpose. This study tested the null hypothesis that different classes of direct restorative dental materials: silorane-based resin, low-shrinkage and conventional (non-flowable and flowable) resin-based composite (RBC) do not differ from each other with regard to polymerization shrinkage, depth of cure or microhardness. Methods. 140 RBC samples were fabricated and tested by one calibrated operator. Polymerization shrinkage was measured using a gas pycnometer both before and immediately after curing with 36 J/cm(2) light energy density. Depth of cure was determined, using a penetrometer and the Knoop microhardness was tested from the top surface to a depth of 5 mm. Results. Considering polymerization shrinkage, the authors found significant differences (p < 0.05) between different materials: non-flowable RBCs showed lower values compared to flowable RBCs, with the silorane-based resin presenting the smallest shrinkage. The low shrinkage flowable composite performed similarly to non-flowable with significant statistical differences compared to the two other flowable RBCs. Regarding to depth of cure, low-shrinkage flowable RBC, were most effective compared to other groups. Microhardness was generally higher for the non-flowable vs. flowable RBCs (p < 0.05). However, the values for low-shrinkage flowable did not differ significantly from those of non-flowable, but were significantly higher than those of the other flowable RBCs. Clinical Significance. RBCs have undergone many modifications as they have evolved and represent the most relevant restorative materials in today's dental practice. This study of low-shrinkage RBCs, conventional RBCs (non-flowable and flowable) and silorane-based composite-by in vitro evaluation of volumetric shrinkage, depth of cure and microhardness-reveals that although filler content is an important determinant of polymerization shrinkage, it is not the only variable that affects properties of materials that were tested in this study.

Objectives: The current study evaluated the effect of accelerated artificial aging (AAA) on the color stability (CS) and degree of conversion (DC) of nanofilled and nanohybrid resin composites associated to different adhesive systems in direct esthetic restorations., Material and Methods: Eighty bovine incisors were used to obtained dentin blocks (4 × 4 × 1 mm). The restorative systems were bonded to the blocks and photoactivated according to the manufacturer's instructions. Three adhesive systems were used: Adper Scotchbond Multi-Purpose (conventional of three steps), Tetric N-Bond (conventional of two steps) and ClearFill SE Bond (self-etching). Also, two composites were used: Filtek Z350 XT (nanofilled) and IPS Empress Direct (nanohybrid). The restorations were made using a silicone mold placed on top of the prepared dentin blocks (N = 10). CS was measured after 300 hours of AAA by means of ultraviolet light using a spectrophotometer and CIE L*a*b* parameters on the top surface of the composite and at the bonded interface. The DC was performed using Fourier transform infrared spectroscopy (N = 10). Data were analyzed using two-way analysis of variance and Tukey's test (α = 0.05)., Results: The adhesive systems had no significant influence on the color stability (ΔE) of either the restoration surface (α = 0.90) or the bonded interface (α = 0.78). However, composite influenced the color as measured by ΔE and isolated coordinates (α < 0.001). The nanohybrid composite showed increased DC values (67%) compared with the nanofilled (61%) with statistically significant differences (α < 0.001)., Conclusions: The adhesive system did not affect the final color of direct esthetic restorations. The nanohybrid composite demonstrated a higher DC and increased color stability after AAA compared to the nanofilled composite., Clinical Significance: The long-term color stability of composite restorations is a critical aspect of esthetic restorative procedures. Optimal Polymerization behavior of resin composite as indicated by the degree of conversion also influence on the color stability after artificial aging of composite restorations., (© 2014 Wiley Periodicals, Inc.)

Purpose: The aim of this study was to evaluate the relaxation in vitro of cavernous smooth muscle induced by a new NO donor of the complex nitrosil-ruthenium, named trans-[Ru(NH3)4(caffeine)(NO)]C13 (Rut-Caf) and sodium nitroprusside (SNP)., Materials and Methods: The tissues, immersed in isolated bath systems, were pre-contracted with phenilephrine (PE) (1 µM) and then concentration-response curves (10 (-12) - 10(-4) M) were obtained. To clarify the mechanism of action involved, it was added to the baths ODQ (10 µM, 30 µM), oxyhemoglobin (10 µM), L-cysteine (100 µM), hydroxicobalamine (100 µM), glibenclamide, iberotoxin and apamine. Tissue samples were frozen in liquid nitrogen to measure the amount of cGMP and cAMP produced., Results: The substances provoked significant relaxation of the cavernous smooth muscle. Both Rut-Caf and SNP determined dose-dependent relaxation with similar potency (pEC50) and maximum effect (E(max)). The substances showed activity through activation of the soluble guanylyl cyclase (sGC), because the relaxations were inhibited by ODQ. Oxyhemoglobin significantly diminished the relaxation effect of the substances. L-cysteine failed to modify the relaxations caused by the agents. Hydroxicobalamine significantly diminished the relaxation effect of Rut-Caf. Glibenclamide significantly increased the efficacy of Rut-Caf (pEC50 4.09 x 7.09). There were no alterations of potency or maximum effect of the substances with the addition of the other ion channel blockers. Rut-Caf induced production of significant amounts of cGMP and cAMP during the relaxation process., Conclusions: In conclusion, Rut-Caf causes relaxation of smooth muscle of corpus cavernosum by means of activation of sGC with intracellular production of cGMP and cAMP; and also by release of NO in the intracellular environment. Rut-Caf releases the NO free radical and it does not act directly on the potassium ion channels.

Objectives: Innumerous modifications have been proposed for the microtensile test since its introduction; however, testing parameters are not often well described and wide variations in bond strength are commonly reported. The aim of this study was to evaluate the effect of the test specimen's gripping device, specimen geometry and fixation method on microtensile bond strength, failure mode, and stress distribution when using an etch-and-rinse 2-step adhesive system bonded to human dentin., Methods: Resin-based composite bonded to occlusal dentin from 21 human molars was used to fabricate dumbbell- and stick-shaped test specimens which were divided into three groups: Di - dumbbell-specimens placed in a Dircks device; GeS - stick-specimens gripped in a Geraldeli's device with Superglue; GeZ - stick-specimens gripped in a Geraldeli's device with Zapit. Specimens were tested to failure in tensile mode and the failure mode was examined under stereomicroscopy and fracture initiation sites were verified by scanning electron microscopy and energy dispersive X-ray spectroscopy. Three-dimensional models of each device/specimen were created and finite element calculations were performed., Results: The effect of the gripping devices on the bond strength was not significant, unless the bond test areas were normalized. The failure mode was influenced by the type of device. Dircks device was less sensitive to human error than Geraldeli's, and produced a more uniform stress distribution at the dumbbell specimen adhesive layer than did the Geraldeli's device at the stick layer., Significance: Microtensile testing parameters can directly influence the results and consequently inter-study comparisons., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)