Marginal adaptation of Class 2 adhesive restorations

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups ( n = 20): ( 1) oblique incremental insertion technique ( control), ( 2) centripetal incremental insertion technique, and ( 3) bulk insertion. The teeth were restored with a total-etch adhesive and micro-hybrid composite resin. The specimens were isolated with nail varnish except for a 2-mm-wide area around the restoration and then thermocycled ( 1,000 thermal cycles, 5 degrees C/ 55 degrees C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores ( 0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests ( P <.05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores ( P =.15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins ( P =.04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques.

Dentine microhardness after different methods for detection and removal of carious dentine tissue

There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. Objectives: The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. Material and methods: The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10), according to the method used to identify and remove the carious tissue: "Papacarie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. Results: ANOVA and Tukey's test (alpha=0.05) were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacarie" (424.7 +/- 105.0; a), Caries-detector dye (370.5 +/- 78.3; ab), Tactile method (322.8 +/- 51.5; bc). Results for the remaining dentin microhardness were: "Papacarie" (42.2 +/- 10.5; bc), Caries-detector dye (44.6 +/- 11.8; bc), Tactile method (24.3 +/- 9.0; d). Conclusions: DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacarie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacarie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.

Evaluation of light transmission through translucent and opaque posts

Objectives: The transmission of light through translucent posts was observed, and the microhardness of light-cured cement used to secure these posts was evaluated at different depths. Methods: Fifteen single-rooted standard bovine teeth, 16 mm in size, were used. The root canals were prepared using #3 drills Light-Post (five teeth) and Aestheti Post (five teeth) systems (BISCO), with a working-length of 12 mm. In five teeth, translucent posts were cemented (Light-Post #2), while another five teeth received opaque posts (Aestheti Post #2). The roots were painted with black nail varnish to prevent the passage of light through the lateral walls of the roots. The root canals of all the specimens were treated with the All-Bond 2 adhesive system (BISCO) and cemented with light-cured cement (Enforce, Dentsply). All the roots were transversally cut to obtain six specimens 1.5 mm thick. Every two sections corresponded to a specific region of the root (cervical, middle, apical), making it possible to observe the cement microhardness at different levels. The groups (n=10) were defined as: G1: translucent post (TP)/cervical region; G2: TP/middle region; G3: TP/apical region; G4: Opaque post (OP)/cervical region; G5: OP/middle region; G6: PO/apical region. Five root canals were only filled with cement for use as a control (G7). Then, Vickers microhardness analyses were performed. Results: In G3, G5 and G6, the cement was not sufficiently hard to allow for microhardness analysis. When submitted to the ANOVA test, G1 (35.07), G2 (24.28) and G4 (28.64) presented no statistical differences. When the previous groups were compared to G7 (51.00) using the Kruskal-Wallis test, a statistical difference was found. Conclusion: Translucent posts allow cement polymerization up to the middle portion of the root.

Marginal leakage in Class V cavities pretreated with different laser energy densities

The purpose of the present study was to evaluate in vitro the degree of marginal leakage in Class V cavities involving the cementoenamel junction. Cavities were 4 rum wide and 2 mm deep. The specimens received dentin pretreatment (37% phosphoric acid) followed by the Single Bond (3M) adhesive system application. The 40 specimens were then divided into four groups: Group I (control); Group 2 (Nd:YAG laser at 120 mJ/pulse, frequency of 10 Hz, power of 1.2 W); Group 3 (Nd:YAG laser at 140 mJ/pulse, frequency of 10 Hz, power of 1.4 W); Group 4 (Nd:YAG laser at 160 mJ/pulse, frequency of 10 Hz, power of 1.6 W). The cavities were restored with Z100 composite resin (3M) and light cured at 300-600 mW/cm(2) light intensity. Specimens were thermocycled to 500 cycles from 2-50 degrees C. After that, they were dried and sealed with nail varnish, respecting 1 mm around the restorations, and immersed in 0.5% methylene blue solution for 4 h. After this period, the teeth were rinsed, dried, sectioned, and analyzed in a stereoscopic loupe. The highest leakage scores were considered for each specimen. The results were statistically analyzed by the analysis of variance (ANOVA) Kruskal-Wallis test to the 5% level. For both the enamel and cementum, there was a decrease in marginal leakage with the application of laser energy; no significant differences were observed for Groups 2, 3, and 4. The results also showed a smaller tendency to marginal leakage on the cementum than on the enamel.

In vitro evaluation of dental bleaching effectiveness using hybrid lights activation

OBJETIVO: Avaliar se fontes de luz aumentam a eficácia do peróxido de hidrogênio na técnica de clareamento profissional. METODOLOGIA: Foram empregados 60 dentes incisivos bovinos, com dimensões coronárias e radiculares padronizadas a partir do limite amelo-cementário, sendo descartada a porção lingual. Os corpos-de-prova (cp) foram limpos em ultra-som por 20 min e a dentina condicionada com H3PO4 a 38% por 15 s, sendo os (cp) imersos em solução de café solúvel a 25% por duas semanas. A dentina foi impermeabilizada com esmalte e os (cp) divididos em 5 grupos, sendo a cor inicial mensurada através do espectofotômetro-EasyShade (VITA). Todos os (cp) receberam três aplicações por 10 min do gel clareador Opalescence Xtra-Boost (Ultradent) conforme segue: Grupo 1 - controle, não recebeu fotoativação, Grupo 2 - ativado com luz halôgena, Grupo 3 - ativado com LED azul/LASER, Grupo 4 - ativado com LED verde/LASER e Grupo 5 - ativado com LED vermelho. Após o clareamento foi mensurada a variação de cor E, a*, b*e L* e as referentes à escala de cor Vita Clássico. Os dados foram submetidos à análise de variância, teste de Tukey e de Dunn (α=5%). RESULTADOS: A diferença geral da cor foi reduzida quando se empregou LED Azul e Luz Halógena, sendo que o desempenho do peróxido de hidrogênio a 38% foi intensificado dependendo da fonte de luz utilizada. A avaliação quantitativa de cor, obtida por espectrofotômetro e pela escala de cor Vita Clássico, foram coincidentes. CONCLUSÃO: O tipo de fonte de luz empregada interfere na eficácia do agente clareador.

Cisticercose intramedular: relato de caso e revisão da literatura

Os autores relatam um caso raro de neurocisticercose intramedular em um paciente do sexo masculino, de 36 anos de idade. Foram realizadas tomografia computadorizada e ressonância magnética do crânio, que evidenciaram múltiplas lesões de tamanhos variados, com realce periférico após injeção de meio de contraste. Também foi realizada ressonância magnética da coluna cervical, que evidenciou formação cística com escólex em seu interior ao nível de C5-C6 na região intramedular.

Superficial acral fibromyxoma of the thumb: a case report

The authors report a case of superficial acral fibromyxioma (SAF) in a 74-year-old male who presented with a painless mass in a periungual dorsoradial region of the right thumb. It is a rare benign neoplasm, which was recently described, that arouse on the skin and subcutaneous tissue of the hands and feet, especially in the proximity to the ungual region of male adults. Surgical treatment was performed with the excision in blocks of the margins of the lesion and fragmentation of the nail and nail matrix, according to the literature recommendation. Although there may be local recurrence in 22% of the cases, the patient presents no symptoms, deformities or functional limitations. In addition, there was no sign of tumor recurrence 18 months after the surgery. We are not aware of a similar case report in the Brazilian literature

Imobilização de fraturas femorais em gatos usando pino intramedular conectado ou não ao fixador esquelético externo

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

Síndrome do gucagonoma em cão

O eritema necrolítico migratório é rara dermatose caracterizada por lesões erodo-ulcerativas e crostosas em áreas intertriginosas, junções mucocutâneas, superfícies articulares e de apoio crônico, que tem sido descrita em seres humanos, cães, gatos e rinocerontes. Sua etiologia tem sido relacionada a neoplasias pancreáticas, mormente das células alfa produtoras de glucagon, e a graves doenças do parênquima hepático ou gastroentérico. Relata-se o caso de um cão com necrose epidérmica metabólica secundária a glucagonoma, que apresenta fortes similaridades com a síndrome do glucagonoma em humanos.

Effect of the composite surface sealant application moment on marginal sealing of compactable composite resin restoration

An analysis was carried out to observe whether the application or not of a composite surface sealant (CSS), as well the moment for CSS application were able to reduce marginal microleakage in compactable composite resin restoration. All the preparations were restored with a compactable composite resin. The restored teeth were randomly assessed. G1 (control group): finished and polished; G2: finished, polished, etched and cover with CSS; G3: immediately after the restoration done the CSS was applied, then finished and polished; G4: CSS applied immediately after the restoration was done, the finished and polished, etched, and covered with CSS. The specimens were isolated with nail polish, thermocycled, immersed in aqueous solution of silver nitrate, and followed in a photo developing solution. The microleakage scores obtained from the occlusal and cervical walls were analyzed with the Kruskall-Wallis nonparametric test. No microleakage was found at the enamel margins. Comparing the microleakage scores at dentin/cementum margins (p < 0.05) it was found that G3 (p = 0.0162) and G4 (p = 0.0187) were able to reduce microleakage when compared with group G2. However the results were not statistically different from the control group. The application of CSS was not able to completely eliminate marginal microleakage at the dentin/cementum margins.

Effectiveness of surface protection for resin-modified glass-ionomer materials

Objective: the purpose of this study was to evaluate the effectiveness of various surface treatments for resin-modified glass-ionomer restorative materials by determining dye uptake spectrophotometrically. Method and materials: Two hundred twenty-four specimens, 4.1 mm in diameter and 2.0 mm thick, were made of 3 materials: Vitremer, Fuji II LC, and Photac-Fil Aplicap. Specimens were divided into 15 groups. The positive and negative control specimens remained unprotected, while the experimental specimens were protected with Heliobond light-activated bonding resin, Colorama nail varnish, or surface coatings indicated by the manufacturers of the glass-ionomer materials. Finishing Gloss for Vitremer, Fuji Varnish for Fuji II LC, and Ketac Glaze for Photac-Fil. The disks were immersed in 0.05% methylene blue for 24 hours except for the negative control group, which was immersed in deionized water. After 24 hours, the disks were removed, washed, and individually placed in 1 mL of 65% nitric acid for 24 hours. The solutions were centrifuged and the spectrophotometric absorbance was determined at 606 nm. The dye uptake was expressed in micrograms of dye per milliliter, and the results were analyzed with the Kruskal-Wallis test. Results: There were no differences in dye uptake among the 3 resin-modified glass-ionomer restorative materials, however, all of them required surface protection. Conclusion: the best surface protection for the 3 evaluated materials was obtained with Heliobond light-activated bonding resin.

Efficacy and safety of itraconazole pulse therapy: Brazilian multicentric study on toenail onychomycosis caused by dermatophytes

Background Itraconazole is a large spectrum triazole with known efficacy in both continuous and pulse therapy for various mycoses.Objectives Evaluate the efficacy and tolerability of itraconazole pulse therapy for onychomycosis of the toenails due to dermatophytes, in a prospective, open, non-comparative and multicentric investigation.Patients and methods the trial was completed by 72 patients of an initial total of 89. Treatment consisted of four cycles of itraconazole, 200 mg twice a day, for seven consecutive days each month. Patients were evaluated clinically, mycologically and biochemically before, during and at the end of the investigation, and were divided into two groups according to the measure of normal portion of the most affected nail (target nail), as follows: Group 1. 0-5.9 mm; and Group 2: more than 6 mm.Results Improvement was satisfactory and progressive. Results were statistically significant, when comparing the three moments of the study: pre-treatment, end of therapy (fourth month) and follow-up (ninth month) in both groups.Conclusions Itraconazole pulse therapy was efficient and safe for the treatment of onychomycosis caused by dermatophytes, although a much higher daily dosage than the known continuous administration was used. Group 1, with nails initially more extensively affected, had a more evident improvement, by the mean variation in millimeters of normal portion of the target nail. This group showed a very satisfactory response, although not reaching total cure, thus demonstrating the great importance of early treatment of this disease. A residual therapeutic effect is maintained even after suspension of the drug. Group 2 obtained better total cure rates, and four pulses were, in general, sufficient, whereas more cycles would have been beneficial for the Group 1 patients with more extensive involvement. (C) 1998 Elsevier B.V. B.V. All rights reserved.

Influence of growth rate and length on fluoride detection in human nails

This study aimed to determine the lag time between increased fluoride (F) intake and F detection in human nails, as well as the influence of nails growth rate and length on this. Ten 20- to 35-year-old volunteers received 1.8 mg F daily, for 30 days. Nail growth rate and length were determined for all fingernails and toenails. Nail samples were collected at the beginning of the study and every 2 weeks (15 collections in all) and F concentrations were determined. The growth rate was statistically higher in fingernails than in toenails. No statistically significant differences were observed between right and left sides. Growth rate was significantly greater for big toenails than for the other toenails, but this pattern was not found for fingernails. The estimated mean lag times for F detection in fingernails and toenails were 101 and 123 days, respectively. An apparent increase in fingernail F concentrations was observed 84 days after the beginning of the study, although this was not statistically different from baseline. For toenails, statistically significant increases in F concentration in relation to baseline were observed 112 and 140 days after increased F ingestion. These increases occurred within the 95% confidence intervals for the calculated mean lag time for fluoride detection in nails. Considering the large amount of sample provided by the big toenails, together with their faster growth rate, as well as the fact that toenails are less prone to environmental contamination, our data suggest that big toenails are more suitable biomarkers of fluoride intake.

Quantification of Peroxide Ion Passage in Dentin, Enamel, and Cementum After Internal Bleaching With Hydrogen Peroxide

The aim of this study was to evaluate the amount of peroxide passage from the pulp chamber to the external enamel surface during the internal bleaching technique. Fifty bovine teeth were sectioned transversally 5 mm below the cemento-enamel junction (CEJ), and the remaining part of the root was sealed with a 2-mm layer of glass ionomer cement. The external surface of the samples was coated with nail varnish, with the exception of standardized circular areas (6-mm diameter) located on the enamel, exposed dentin, or cementum surface of the tooth. The teeth were divided into three experimental groups according to exposed areas close to the CEJ and into two control groups (n=10/group), as follows: GE, enamel exposure area; GC, cementum exposed area; GD, dentin exposed area; Negative control, no presence of internal bleaching agent and uncoated surface; and Positive control, pulp chamber filled with bleaching agent and external surface totally coated with nail varnish. The pulp chamber was filled with 35% hydrogen peroxide (Opalescence Endo, Ultradent). Each sample was placed inside of individual flasks with 1000 mu L of acetate buffer solution, 2 M (pH 4.5). After seven days, the buffer solution was transferred to a glass tube, in which 100 mu L of leuco-crystal violet and 50 mu L of horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to Kruskal-Wallis and Dunn-Bonferroni tests (alpha=0.05). All experimental groups presented passage of peroxide to the external surface that was statistically different from that observed in the control groups. It was verified that the passage of peroxide was higher in GD than in GE (p<0.01). The GC group presented a significantly lower peroxide passage than did GD and GE (p<0.01). It can be concluded that the hydrogen peroxide placed into the pulp chamber passed through the dental hard tissues, reaching the external surface and the periodontal tissue. The cementum surface was less permeable than were the dentin and enamel surfaces.

Clinical evaluation of the association of noncarious cervical lesions, parafunctional habits, and TMD diagnosis

Objective: To verify a potential association between the presence of noncarious cervical lesions, parafunctional habits, and temporomandibular disorder (TMD) diagnosis. Method and Materials: Sample-size calculation provided a value of 130 participants with a confidence level of 95% and an error margin of 5%. A population of 132 volunteers (30 men: mean age, 23.7 +/- 3.05 years; 102 women: mean age, 24.9 +/- 5.86 years) underwent an oral examination and was interviewed by a trained dentist. The following parameters were registered: personal details, TMD diagnosis, parafunctional habits, and noncarious cervical lesion presence. The population was then divided into a noncarious cervical lesion group and a control group and subjected to the t test, chi-square test, Fisher exact test, and Spearman correlation (alpha = .05). Results: Noncarious cervical lesions were present in 39% of the population, with the largest concentrations found in the maxillary premolars (32%). The data showed a significant association between noncarious cervical lesion presence, tooth clenching (P = .03), and nail biting (P = .02), as well as a relation with TMD diagnosis (Fonseca Index [P = .01] and Research Diagnostic Criteria for TMD (RDC/TMD) [P = .004] ). In the noncarious cervical lesion group, direct rank correlation was found between maxillary premolars and clenching (P = .03), mandibular canines and nail biting (P = .05), and mandibular incisors and parafunctional habits without dental contacts (P = .02). Conclusion: Parafunctional habits and TMD presence should be taken into account in the diagnosis and treatment plan of noncarious cervical lesions.