Biomechanics Studies in Dentistry: Bioengineering Applied in Oral Implantology

The application of engineering knowledge in dentistry has helped the understanding of biomechanics aspects related to osseointegrated implants. Several techniques have been used to evaluate the biomechanical load oil implants comprising the use of photoelastic stress analysis, finite element stress analysis, and strain-gauge analysis. Therefore, the purpose of this Study was to describe engineering methods used in dentistry to evaluate the biomechanical behavior of osseointegrated implants. Photoelasticity provides good qualitative information oil the overall location and concentration of stresses but produces limited quantitative information. The method serves as ail important tool for determining the critical stress points in a material and is often used for determining stress concentration factors in irregular geometries. The application of strain-gauge method oil dental implants is based oil the use of electrical resistance strain gauges and its associated equipment and provides both in vitro and vivo measurements strains under static and dynamic loads. However, strain-gauge method provides only the data regarding strain at the gauge. Finite element analysis can Simulate stress using a computer-created model to calculate stress, strain, and displacement. Such analysis has the advantage of allowing several conditions to be changed easily and allows measurement of stress distribution around implants at optional points that are difficult to examine clinically All the 3 methodologies call be useful to evaluate biomechanical implant behavior close to the clinical condition but the researcher should have enough knowledge in model fabrication (experimental delineation) and results analysis.

Influence of Different Ceramics on Resin Cement Knoop Hardness Number

This study evaluated: 1) the effect of different ceramics on light attenuation that could affect microhardness, measured as the Knoop Hardness Number (KHN), of a resin cement immediately and 24 hours after polymerization and 2) the effect of different activation modes (direct light-activation, light activation through ceramics and chemical activation) on the KHN of a resin cement.Resin cement Rely X ARC (3M ESPE) specimens 5.0 mm in diameter and 1.0 nun thick were made in a Teflon mold covered with a polyester film. The cement was directly light activated for 40 seconds with an XL 2500 curing unit (3M ESPE) with 650 mW/cm(2), light activated through ceramic discs of Duceram Plus (DeguDent), Cergogold (DeguDent), IPS Empress (Ivoclar), IPS Empress 2 (Ivoclar), Procera. (NobelBiocare), In Ceram Alumina (Vita) and Cercon (DeguDent), having a 1.2 mm thickness or chemically activated without light application. The resin cement specimens were flattened, and KHN was obtained using an HMV 2 microhardness tester (Shimadzu) with a load of 50 g applied for 15 seconds 100 pin from the irradiated surface immediately and after storage at 37 degrees C for 24 hours. Ten measurements were made for each specimen, with three specimens for each group at each time. The data were submitted to ANOVA and Tukey's test (p=0.05). The KHN of the resin cement was not only affected by the mode of activation, but also by the post-activation testing time. The mean KHN of the resin cement for chemical activation and through all ceramics showed statistically significant lower values compared to direct activation immediately and at 24 hours. The KHN for 24 hours post-activation was always superior to the immediate post-activation test except with direct activation. The most opaque ceramics resulted in the lowest KHN values.

In Vitro Evaluation of Surface Roughness and Microhardness of Restorative Materials Submitted to Erosive Challenges

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fluoride release/recharge from restorative materials: effect of fluoride gels and time

This study examined the differences in fluoride release and recharge among four restorative materials following treatment with APF or neutral fluoride gel for one or four minutes. Specimens were immersed in 2 mL of deionized water, while fluoride release was measured at 24-hour intervals for 15 days using an ion-selective electrode and analyzer. The materials were then treated with the fluoride gels. The fluoride release was measured for 15 days. ANOVA (p<0.05) showed higher fluoride release for Ketac-Fil before fluoride application and for Vitremer and Fuji 11 LC after application of APF gel. APF gel yielded higher fluoride release when compared to neutral gel, regardless of the material. Fluoride recharge and release was greater after the four-minute APF gel application, with no difference between the times of application for the neutral gel (p>0.05), except for Ketac-Fil. The pattern of release before and after application of the gels was similar and was higher at day 16 compared to day one for the APF gel for resin materials, with higher release at day 15 compared to the initial for Fuji 11 LC and Vitremer. Et was concluded that RM-GICs were the most effective materials with regards to fluoride release after application of APF gel for four minutes.

Art in the inclusion of children with special needs in dentistry

A proposta deste estudo é relatar a utilização da arte e seus segmentos, como recurso para inclusão da criança portadora de necessidades especiais ao ambiente odontológico. Foi utilizado como método a aplicação da arte em atividades de socioterapia e oficinas, divididas em módulos: sessão de socialização, oficinas de arte e atividades complementares, visando à elaboração de uma anamnese cultural por meio de questionários e a obtenção das preferências artísticas dos 313 participantes, previamente às suas assistências odontológicas no CAOE (Centro de Assistência Odontológica a Portadores de Necessidades Especiais) FOA/Unesp. de acordo com os questionários respondidos, a música e a pintura, segundo a preferência dos participantes, são os segmentos artísticos que mais auxiliam nas atividades de inclusão e adaptação. Concluímos que a utilização da arte na adaptação e inclusão ambiental do paciente, previamente à assistência odontológica, é favorável e eficaz.

Sexual harassment in Dentistry: prevalence in dental school

Objective: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. Material and Methods: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82% (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. Results: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR = 2.910 (1.113-7.611)]. Additionally, 25.4% of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. Conclusion: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Effect of erosive pH cycling on different restorative materials and on enamel restored with these materials

This in vitro study evaluated the effect of erosive pH cycling on the percentage of surface micro-hardness change (%SMHC) and wear of different restorative materials and bovine enamel restored with these materials. Eighty enamel specimens were randomly divided into eight groups according to the restorative materials and immersion media used: GI/GV-resin-modifled glass-ionomer, GII/GVI-conventional glass-ionomer, GIII/GVII-resin composite and GIV/GVIII-amalgam. Over a period of seven days, groups GI to GIV were immersed in a cola drink (ERO) for 5 minutes, 3x/day and kept in artificial saliva between erosive cycles. Groups GV to GVIII were immersed in artificial saliva (SAL) throughout the entire experimental period (control). Data were tested for significant differences using ANOVA and Tukey's tests (p < 0.05). For %SMHC, considering the restorative materials, no significant differences were detected among the materials and immersion media. Mean wear was higher for the resin modified glass ionomer cement when compared to conventional cement, but those materials did not significantly differ from the others. For enamel analyses, erosive pH cycling promoted higher wear and %SMHC compared to saliva. There were no significant differences in wear and %SMHC of enamel around the different restorative materials, regardless of the distance from the restorative material (50, 150 or 300 mu m). In conclusion, there were only subtle differences among the materials, and these differences were not able to protect the surrounding enamel from erosion.

Dentistry in Brazil: Its History and Current Trends

The objectives of this article are to provide a short history of dentistry and dental education in Brazil and to analyze the nature of its development to date. The databases consulted are those provided by the Brazilian Federal Council of Dentistry, Brazilian Ministry of Health, Brazilian Ministry of Education, National Institute of Studies and Educational Research Anisio Teixeira, and Brazilian Institute of Geography and Statistics. Formal dental education in Brazil started in the late nineteenth century with the creation of courses annexed to existing schools of medicine in Rio de Janeiro and Bahia. Today, there are 191 institutions of higher education nationwide granting degrees in dentistry (137 private [71.7 percent] and fifty-four public [28.3 percent]), with a total of 17,157 student positions offered annually. These schools graduate around 10,000 professionals per year-one of the highest rates in the world. Both the distribution of schools of dentistry and of dentists varies among the regions of the country, with the greatest concentrations in major metropolitan centers with high population density, resulting in limited coverage in the more deprived regions. A review of epidemiological data for oral health and distribution of dentists in Brazil indicates that there is a lack of systematic planning for the allocation of the dental workforce and a lack of consideration of regional needs in the development of dental training programs in Brazil today.

Clinical assessment of postoperative sensitivity in posterior composite restorations

This incidence of postoperative sensitivity was evaluated in resin-based posterior restorations. Two hundred and ninety-two direct restorations were evaluated in premolars and molars. A total of 143 Class I and 149 Class 11 restorations (MO/OD and MOD) were placed in patients ranging in age from 30 to 50 years. After the cavity preparations were completed, a rubber dam was placed, and the preparations were restored using a total-etch system (Prime & Bond NT) and a resin-based restorative material (TPH Spectrum). The patients were contacted after 24 hours and 7, 30 and 90 days postoperatively and questioned regarding the presence of sensitivity and the stimuli that triggered that sensitivity. The Chi-square and Fisher's Exact Test were used for statistical analysis. Evaluation at 24 hours after restorative treatment revealed statistically significant differences among the types of cavity preparations restored and the occurrence of postoperative sensitivity (p=0.0003), with a higher frequency of sensitivity in Class H MOD restorations (26%), followed by Class II MO/DO (15%) and Class I restorations (5%). At 7, 30 and 90 days after restorative treatment, there was a decrease in the occurrence of sensitivity for all groups. The percentage of sensitivity among the groups was not significantly different. This study shows that the occurrence of sensitivity is correlated with the complexity of the restoration.

The influence of temperature of three adhesive systems on bonding to ground enamel

This study evaluated the microtensile bond strength test (mu T), micromorphology of resin-enamel interface (RET) and etching patterns (EP) promoted by the etch-and-rinse adhesive, Prime&Bond NT (PB), and two self-etching adhesives, Clearfil SE Bond (SE) and Adper Prompt L-Pop (APR), to ground bovine enamel surfaces' when applied at temperatures of 5 degrees C (C), 40 degrees C (H) and 20 degrees C (R). Materials and Methods. Sixty-three bovine incisors were randomly divided into nine experimental groups (n=7) according to adhesive systems and temperatures. The buccal enamel surfaces were flattened with 600-grit SiC paper and abraded with a diamond bur under water-cooling. The adhesive systems were applied according to the manufacturer's instructions. After the restorative procedures, the specimens were sectioned into five slabs. Four slabs were prepared for mu T and one for interface analysis. For etching pattern analysis, the remaining 16 bovine enamel fragments were used (n=2). The adhesives were applied and the surfaces were rinsed with organic solvents after application. The specimens for RET and EP analysis were prepared for SEM analysis. Results. No significant differences among the adhesives were found at R temperature. However, at 5 degrees C, PB and APR presented lower bond strength than SE. At H temperature, higher bond strength was observed for PB than for APR and SE. At C and H temperature, formation of the interdiffusion zone was impaired and the treated enamel surfaces presented an undefined EP.

Shear Bond Strength of Different Repair Systems to Titanium After Water Aging

This study evaluated the shear bond strength (SBS) and stability of commercially pure titanium (CP Ti)/repair material interfaces promoted by different repair systems. One hundred CP Ti cast discs were divided into five repair system groups: 1) Epricord (EP); 2) Bistite 11 DC (BT); 3) Cojet (CJ); 4) Scotchbond Multi-Purpose Plus (SB) (control group); and 5) Cojet Sand plus Scotchbond Multi-Purpose Plus (CJSB). The specimens were stored in distilled water for 24 hours at 37 degrees C, thermal cycled (5000 cycles, 5 degrees-55 degrees C) and stored under the same conditions for either 24 hours or six months (n=10). SBS was tested and the data were analyzed by two-way analysis of variance (ANOVA) and Tukey test (alpha=.05). Failure mode was determined with a stereomicroscope (20x). The repair system, storage time, and their interaction significantly affected the SBS (p<0.001). At 24 hours, CJSB exhibited the highest SBS value, followed by CJ. At six months, these two groups had similar mean SBS (p>0.05) and higher means in comparison to the other groups. For both storage times, BT presented the lowest SBS, while the EP and SB groups did not differ significantly from one another (p>0.05). There were no significant differences in SBS between the storage times for the groups EP and CJ (p>0.05). The groups BT, SB, and CJSB showed 100% adhesive failure, irrespective of storage time. The CJSB group showed the highest SBS at both storage times. At six months, the CJ group exhibited a similar SBS mean value when compared to the CJSB group. Water storage adversely affected the groups BT, SB (control group), and CJSB. Considering SBS values, stability, and the failure mode simultaneously, the CJ group showed the best CP Ti repair performance.

Effect of Conventional and Resin-modified Glass-Ionomer Liner on Dentin Adhesive Interface of Class I Cavity Walls After Thermocycling

Objective: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling.Materials and Methods: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5 degrees C-55 degrees C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 nun x 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p < 0.05).Results: There was no detectedstatistical difference on bond strength among groups (alpha < 0.05). Confocal microscopy analysis showed a higher mean gap size in group 4(12.5 mu m) and a higher percentage of marginal gaps in the thermocycled groups. The RNIGIC liner groups showed the lowest percentage of marginal gaps.Conclusions: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Effect of dentin conditioning time on nanoleakage

Objectives: To study the nanoleakage pattern in the dentin hybrid layer by using different dentin adhesives. The null hypotheses tested in this study were: 1) dentin conditioning time does not affect nanoleakage within the hybrid layer; 2) the type of dentin adhesive used does not affect nanoleakage. Methods: Standardized Class V cavities were prepared in 30 intact human molars on the buccal and lingual surfaces. The specimens were randomly assigned to 2 total-etch dentin adhesives (OptiBond SOLO Plus [OPS, Kerr] and One-Step [ONS, BISCO Inc]) and 2 self-etch dentin adhesives (Clearfil SE Bond [CSE, Kuraray] and Adper Prompt L-Pop [APL, 3M ESPE]). The specimens were etched or conditioned for 15 seconds, 30 seconds or 60 seconds. Upon restoration of the Class V cavities with the proprietary resin composite, the specimens were isolated with nail polish except for a 2.0-mm rim around the restoration, and they were immersed in 50 wt% ammoniacal silver nitrate solution (pH=9.5) for 24 hours followed by 8 hours of immersion in photo-developing solution to reduce the silver ions to metallic silver. The specimens were fixed, dehydrated and processed for FESEM and TEM. Silver penetration was measured along the cervical wall, and data were analyzed with Kruskal-Wallis non-parametric tests at a significance level of 95%. Results: There were no statistically significant differences among the experimental groups for the factor conditioning time (p>0.926). There were significant differences for the variable dentin adhesive (p<0.0001). The least amount of nanoleakage within the hybrid layer occurred with CSE, while ONS resulted in the greatest penetration of silver ions. The adhesives OPS and APL ranked in the intermediary subset. Under TEM, all adhesives resulted in some degree of nanoleakage within the hybrid layer. Both spotted/reticular and water-tree nanoleakage patterns were observed. Significance: Longer conditioning times did not increase nanoleakage within the hybrid layer. Nanoleakage varied with the type of adhesive used.