Resumo em Inglês:

Dental erosion is defined as the loss of tooth substance by acid exposure not involving bacteria. The etiology of erosion is related to different behavioral, biological and chemical factors. Based on an overview of the current literature, this paper presents a summary of the preventive strategies relevant for patients suffering from dental erosion. Behavioral factors, such as special drinking habits, unhealthy lifestyle factors or occupational acid exposure, might modify the extent of dental erosion. Thus, preventive strategies have to include measures to reduce the frequency and duration of acid exposure as well as adequate oral hygiene measures, as it is known that eroded surfaces are more susceptible to abrasion. Biological factors, such as saliva or acquired pellicle, act protectively against erosive demineralization. Therefore, the production of saliva should be enhanced, especially in patients with hyposalivation or xerostomia. With regard to chemical factors, the modification of acidic solutions with ions, especially calcium, was shown to reduce the demineralization, but the efficacy depends on the other chemical factors, such as the type of acid. To enhance the remineralization of eroded surfaces and to prevent further progression of dental wear, high-concentrated fluoride applications are recommended. Currently, little information is available about the efficacy of other preventive strategies, such as calcium and laser application, as well as the use of matrix metalloproteinase inhibitors. Further studies considering these factors are required. In conclusion, preventive strategies for patients suffering from erosion are mainly obtained from in vitro and in situ studies and include dietary counseling, stimulation of salivary flow, optimization of fluoride regimens, modification of erosive beverages and adequate oral hygiene measures.

Resumo em Inglês:

The purpose of this work was to develop a model system to study antimicrobial strategies in endodontic biofilms. Enterococcus faecalis suspension was colonized in 10 human root canals. Five milliliters of Brain Heart Infusion (BHI) were mixed with 5 mL of the bacterial inoculums (E. faecalis) and inoculated with sufficient volume to fill the root canal during 60 days. This procedure was repeated every 72 h, always using 24-h pure culture prepared and adjusted to No. 1 MacFarland turbidity standard. Biofilm formation was analyzed by scanning electron microscopy (SEM). E. faecalis consistently adhered to collagen structure, colonized dentin surface, progressed towards the dentinal tubules and formed a biofilm. The proposed biofilm model seems to be viable for studies on antimicrobial strategies, and allows for a satisfactory colonization time of selected bacterial species with virulence and adherence properties.

Resumo em Inglês:

The aim of this study was to evaluate in vitro the marginal sealing of two adhesive systems and to analyze the influence of human and bovine substrates on marginal microleakage in enamel. Rectangular-shaped class V cavities (4 mm wide x 2 mm high x 2 mm deep) were made as follows: 8 cavities were prepared on the buccal and lingual surfaces of the human teeth with margins located on enamel and 16 cavities were prepared on the buccal surfaces of the bovine teeth. The cavities were randomly assigned to 4 groups of 8 cavities according to the adhesive system and substrate: G1 - Prime & Bond 2.1 (Dentsply)/human substrate; G2 - Adhese (Ivoclar/Vivadent)/human substrate; G3 - Prime & Bond 2.1 (Dentsply)/bovine substrate; G4 - Adhese (Ivoclar/Vivadent)/bovine substrate. The cavities were filled with microhybrid composite resin (Fillmagic) and after polishing/finishing procedures, the teeth were subjected to a thermocycling regimen of 500 cycles with 1-min immersions in water at 55° ±2°C and 5° ± 2°C. Next, the teeth were coated with two layers of nail polish to within 1 mm of the margin, submerged in a 50% silver nitrate solution for 2 h, rinsed thoroughly in running tap and immersed in developing solution for 8 h. The restorations were bisected resulting in 16 specimens. Microleakage was observed under a stereomicroscope at x25 and recorded using four-point (0-3) scoring system. The data were analyzed statistically by the Mann Whitney U-test at 5% significance level. Leakage was present in all specimens and there was statistically significant difference between the adhesive systems. Adhese self-etching system showed significantly more leakage in both substrates (human - p= 0.0001 and bovine - p= 0.0031). There was no statistically significant difference between human and bovine substrates for either of the adhesive systems based on different bonding mechanisms (Prime & Bond 2.1 - p= 0.6923 and Adhese - p= 0.6109). Neither of the adhesive systems was capable to completely prevent microleakage and the self-etching system was more susceptible to microleakage.

Resumo em Inglês:

The aim of this study was to describe the attitude and subjective norm of dental practitioners towards practicing the atraumatic restorative treatment (ART) in Tanzania. A pre-tested questionnaire on attitudes and subjective norms to practice ART was mailed to all 147 dental practitioners working in the regional and district government clinics. The independent variables were: gender, working experience, qualification and ever heard of ART. The dependent variables were: attitude, subjective norm and intention to practice ART. Chi-square tests and multiple regression analysis were used to test for effects between independent and dependent variables. Significance level was set at 5%. A total of 138 practitioners returned completed questionnaires. More experienced dental practitioners encountered moderate social pressure than less experienced dental practitioners, who met strong social pressure (p=0.045). A total of 73.2% of dental practitioners felt that ART was worth introducing in Tanzania, 92.8% recommended ART training for all dental practitioners and 97.8% recommended inclusion of ART in dental curricula. Positive attitude, strong subjective norm and high intention to practice ART were recorded in 76.3%, 28.1% and 90.6% of the practitioners, respectively. Only subjective norm had a statistically significant influence on the intention to practice ART (p<0.0001). The results indicated that dental practitioners were willing to have ART introduced in Tanzania and had positive attitudes towards practicing this technique. Nevertheless, their intention to perform ART was strongly influenced by social pressures. Therefore, in order to have a successful introduction of ART in Tanzania, people who matter in the daily practice of dental practitioners need to accept and appraise the ART approach positively.

Resumo em Inglês:

Fluorinated denture base acrylic resins can present more stable physical properties when compared with conventional polymers. This study evaluated the incorporation of a fluoroalkyl methacrylate (FMA) mixture in a denture base material and its effect on roughness and flexural strength. A swelling behavior assessment of acrylic resin specimens (n=3, per substance) after 12 h of FMA or methyl methacrylate (MMA) immersion was conducted to determine the solvent properties. Rectangular specimens (n=30) were allocated to three groups, according to the concentration of FMA substituted into the monomer component of a heat-polymerized acrylic resin (Lucitone 550), as follows: 0% (control), 10% and 20% (v/v). Acrylic resin mixed with concentrations of 25% or more did not reach the dough stage and was not viable. The surface roughness and flexural strength of the specimens were tested. Variables were analyzed by ANOVA and Tukey's test (a=0.05). Immersion in FMA produced negligible swelling, and MMA produced obvious swelling and dissolution of the specimens. Surface roughness at concentrations of 0%, 10% and 20% were: 0.25 ± 0.04, 0.24 ± 0.04, 0.22 ± 0.03 mm (F=1.78; p=0.189, not significant). Significant differences were found for flexural strength (F=15.92; p<0.001) and modulus of elasticity (F=7.67; p=0.002), with the following results: 96 ± 6, 82 ± 5, 84 ± 6 MPa, and 2,717 ± 79, 2,558 ± 128, 2574 ± 87 MPa, respectively. The solvent properties of FMA against acrylic resin are weak, which would explain why concentrations over 20% were not viable. Surface changes were not detected after the incorporation of FMA in the denture base acrylic resin tested. The addition of FMA into denture base resin may lower the flexural strength and modulus of elasticity, regardless of the tested concentration.

Resumo em Inglês:

The purpose of this study was to investigate the effect of different polishing methods on color stability of posterior, universal and nanohybrid composite resin restorative materials upon exposure to a staining agent. Twenty-five specimens were prepared for each of 5 different composite resins (Filtek Z250, Filtek P60, Quadrant LC, Grandio and Filtek Supreme). Specimens were divided into 5 groups and different polishing procedures, including polishing discs (Pd), polishing discs then diamond polishing paste (PdP), polishing discs then a liquid polishing system (Biscover) (PdB), and combinations of these (PdPB) were used. Unpolished specimens served as the control (C). The specimens were stored for 48 h in a coffee solution. The color of all specimens was measured before and after exposure with a colorimeter, and total color change (DE*) were calculated. The data were analyzed with a two-way ANOVA and the means were compared by Tukey HSD test (a=0.05). The lowest color difference was observed in the groups PdP and C, while the highest color difference was observed in PdPB, and PdB. When comparing the five different restorative materials, no significant difference was observed between FiltekP60 and FiltekZ250, and these materials demonstrated significantly less color change than Quadrant LC and the nanohybrid materials (Grandio, Filtek Supreme). The posterior (Filtek P60) and universal (Filtek Z250) composite resin restorative materials, which do not contain tetraethyleneglycol dimethacrylate (TEGDMA), were found to be less stainable than the nanohybrid (Grandio, Filtek Supreme) and universal (Quadrant LC) composite resins, which contain TEGDMA. The use of diamond polishing paste after polishing with polishing discs significantly decreased staining when compared to the groups that used polishing discs alone, for all restorative materials tested. The highest color change values were obtained for the specimens that were polished with the Biscover liquid polish system (PdB and PdPB groups).

Resumo em Inglês:

This study evaluated quantitatively and qualitatively the effect of the storage time of samples before the application of the cell lysis solution (CLS) for extracting DNA from buccal cells (BC). BC from the upper and lower gutter region were collected from 5 volunteers using special cytobrushes (Gentra), totaling 3 collections for each individual. In the control group (n=10), CLS was applied soon after BC collection. In the other two groups, samples were stored at room temperature (n=10) or at 4°C (n=10). After CLS application, DNA was extracted according to the manufacturer's instructions (Puregene DNA Buccal Cell Kit; Gentra Systems, Inc.). The DNA obtained was evaluated by two calibrated blind examiners using spectrophotometry and analysis of DNA bands (0.8% agarose gel electrophoresis). The obtained data were submitted to one-way ANOVA. The means and standard deviations for DNA extracted under immediate, room temperature and cooling temperature conditions were 3.5 ± 0.7, 3.0 ± 0.6 and 4.1 ± 1.8 µg, respectively (p=0.385). No significant differences were found in relation to the amount of DNA for the different storage conditions. However, in the visual analysis of the DNA bands, no trace of DNA degradation was detected when CSL was applied soon after DNA collection, while DNA bands with degradation could be observed in the other groups. Within the limitations of the study, it may be concluded that CLS should be applied soon after DNA collection in order to obtain high-quality DNA from BC.

Resumo em Inglês:

The association between a toothbrush and a dentifrice is the most used denture cleaning method. The purpose of this study was to evaluate the abrasiveness of specific and non-specific denture cleaning dentifrices on different heat-polymerized acrylic resins. Sixteen specimens (90x30x3mm) of each acrylic resin (QC-20, Lucitone 550, Clássico, Vipi-Cril) were prepared and randomly assigned to 4 groups: 1: control (distilled water), 2: Colgate, 3: Bonyplus and 4: Dentu-Creme. The specimens were subjected to simulated toothbrushing in an automatic brushing machine using 35,600 brush strokes for each specimen. Brushing abrasion run at a 200-g load with the specimens immersed in 2:1 dentifrice/water slurry. Specimens were reconditioned to constant mass and the mass loss (mg) was evaluated. Data were analyzed by 2-way ANOVA and Tukey's test (a=0.05). Analysis of dentifrices' abrasive particles was made by scanning electron microscopy. Colgate produced the greatest mass reduction (42.44 mg, p<0.05), followed by Dentu-Creme (33.60 mg). Bonyplus was the less abrasive (19.91 mg), similar to the control group (19.69 mg) (p>0.05). The mass loss values indicated that QC-20 (33.13 mg) and Lucitone 550 (33.05 mg) resins were less (p<0.05) resistant to abrasion than Clássico (26.04 mg) and Vipi-Cril (23.43 mg). In conclusion, Colgate produced the greatest abrasion. Specific dentifrices for dentures tend to cause less damage to acrylic resins.

Resumo em Inglês:

The purpose of this study was to evaluate the metal-ceramic bond strength (MCBS) of 6 metal-ceramic pairs (2 Ni-Cr alloys and 1 Pd-Ag alloy with 2 dental ceramics) and correlate the MCBS values with the differences between the coefficients of linear thermal expansion (CTEs) of the metals and ceramics. Verabond (VB) Ni-Cr-Be alloy, Verabond II (VB2), Ni-Cr alloy, Pors-on 4 (P), Pd-Ag alloy, and IPS (I) and Duceram (D) ceramics were used for the MCBS test and dilatometric test. Forty-eight ceramic rings were built around metallic rods (3.0 mm in diameter and 70.0 mm in length) made from the evaluated alloys. The rods were subsequently embedded in gypsum cast in order to perform a tensile load test, which enabled calculating the CMBS. Five specimens (2.0 mm in diameter and 12.0 mm in length) of each material were made for the dilatometric test. The chromel-alumel thermocouple required for the test was welded into the metal test specimens and inserted into the ceramics. ANOVA and Tukey's test revealed significant differences (p=0.01) for the MCBS test results (MPa), with PI showing higher MCBS (67.72) than the other pairs, which did not present any significant differences. The CTE (10-6 oC-1) differences were: VBI (0.54), VBD (1.33), VB2I (-0.14), VB2D (0.63), PI (1.84) and PD (2.62). Pearson's correlation test (r=0.17) was performed to evaluate of correlation between MCBS and CTE differences. Within the limitations of this study and based on the obtained results, there was no correlation between MCBS and CTE differences for the evaluated metal-ceramic pairs.

Resumo em Inglês:

The use of an adequate method for evaluation of the adhesion of root canal filling materials provides more reliable results to allow comparison of the materials and substantiate their clinical choice. The aims of this study were to compare the shear bond strength (SBS) test and push-out test for evaluation of the adhesion of an epoxy-based endodontic sealer (AH Plus) to dentin and gutta-percha, and to assess the failure modes on the debonded surfaces by means of scanning electron microscopy (SEM). Three groups were established (n=7): in group 1, root cylinders obtained from human canines were embedded in acrylic resin and had their canals prepared and filled with sealer; in group 2, longitudinal sections of dentin cylinders were embedded in resin with the canal surface smoothed and turned upwards; in group 3, gutta-percha cylinders were embedded in resin. Polyethylene tubes filled with sealer were positioned on the polished surface of the specimens (groups 2 and 3). The push-out test (group 1) and the SBS test (groups 2 and 3) were performed in an Instron universal testing machine running at crosshead speed of 1 mm/min. Means (±SD) in MPa were: G1 (8.8±1.13), G2 (5.9±1.05) and G3 (3.8±0.55). Statistical analysis by ANOVA and Student's t-test (a=0.05) revealed statistically significant differences (p<0.01) among the groups. SEM analysis showed a predominance of adhesive and mixed failures of AH Plus sealer. The tested surface affected significantly the results with the sealer reaching higher bond strength to dentin than to gutta-percha with the SBS test. The comparison of the employed methodologies showed that the SBS test produced significantly lower bond strength values than the push-out test, was skilful in determining the adhesion of AH Plus sealer to dentin and gutta-percha, and required specimens that could be easily prepared for SEM, presenting as a viable alternative for further experiments.

Resumo em Inglês:

The purpose of this study was to evaluate the masticatory function of subjects with cleft lip and palate by analyzing the bite force developed by these individuals. Bite force was evaluated in a group of 27 individuals with repaired unilateral cleft lip and palate (14 males and 13 females - aged 18-26 years) and compared to the data achieved from a group of 20 noncleft subjects (10 males and 10 females - aged 18-26 years). Measurement was achieved on three positions within the dental arch (incisors, right molars and left molars), three times at each position considering the highest value for each one. Statistical analysis was performed by ANOVA and Mann-Whitney test ( α = 5%). There was a significant deficit in bite force in male individuals with cleft lip and palate compared to the male control group (p=0.02, p=0.004, p=0.003 for incisors, right and left molars, respectively). For the female group, the difference was not statistically significant (p=0.79, p=0.06, p=0.47). In the group of individuals with clefts, 92.6% were under orthodontic treatment, which could be a reason for the present findings, since it can decrease the bite force more remarkably in males than in females. In conclusion, the bite force is significantly reduced in men when comparing the cleft group to the noncleft group. In females, this reduction was not significant in the same way. However, the main reason for this reduction and for the different behavior between genders should be further investigated.

Resumo em Inglês:

The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.