Effect of thickness of indirect restoration and distance from the light-curing unit tip on the hardness of a dual-cured resin cement

This study evaluated the Knoop hardness and polymerization depth of a dual-cured resin cement, light-activated at different distances through different thicknesses of composite resin. One bovine incisor was embedded in resin and its buccal surface was flattened. Dentin was covered with PVC film where a mold (0.8-mm-thick and 5 mm diameter) was filled with cement and covered with another PVC film. Light curing (40 s) was carried out through resin discs (2, 3, 4 or 5 mm) with a halogen light positioned 0, 1, 2 or 3 mm from the resin surface. After storage, specimens were sectioned for hardness measurements (top, center, and bottom). Data were subjected to split-plot ANOVA and Tukey's test (α=0.05). The increase in resin disc thickness decreased cement hardness. The increase in the distance of the light curing tip decreased hardness at the top region. Specimens showed the lowest hardness values at the bottom, and the highest at the center. Resin cement hardness was influenced by the thickness of the indirect restoration and by the distance between the light-curing unit tip and the resin cement surface.

Effectiveness of rotary or manual techniques for removing a 6-year-old filling material

The aim of this study was to evaluate the effectiveness of manual and rotary instrumentation techniques for removing root fillings after different storage times. Twenty-four canals from palatal roots of human maxillary molars were instrumented and filled with gutta-percha and zinc-oxide eugenol-based sealer (Endofill), and were stored in saline for 6 years. Non-aged control specimens were treated in the same manner and stored for 1 week. All canals were retreated using hand files or ProTaper Universal NiTi rotary system. Radiographs were taken to determine the amount of remaining material in the canals. The roots were vertically split, the halves were examined with a clinical microscope and the obtained images were digitized. The images were evaluated with AutoCAD software and the percentage of residual material was calculated. Data were analyzed with two-way ANOVA and Tukey's test at 5% significance level. There was no statistically significant differences (p>0.05) between the manual and rotary techniques for filling material removal regardless the ageing effect on endodontic sealers. When only the age of the filling material was analyzed microscopically, non-aged fillings that remained on the middle third of the canals presented a higher percentage of material remaining (p<0.05) compared to the aged sealers and to the other thirds of the roots. The apical third showed a higher percentage of residual filling material in both radiographic and microscopic analysis when compared to the other root thirds. In conclusion, all canals presented residual filling material after endodontic retreatment procedures. Microscopic analysis was more effective than radiographs for detection of residual filling material.

Effect of surface treatments on the bond strength of a resin cement to commercially pure titanium

Investigation of the effectiveness of surface treatments that promote a strong bond strength of resin cements to metals can contribute significantly to the longevity of metal-ceramic restorations. This study evaluated the effect of surface treatments on the shear bond strength (SBS) of a resin cement to commercially pure titanium (CP Ti). Ninety cast CP Ti discs were divided into 3 groups (n=30), which received one of the following airborne-particle abrasion conditions: (1) 50 μm Al2O3 particles; (2) 30 μm silica-modified Al2O3 particles (Cojet Sand); (3) 110 μm silica-modified Al2O3 particles (Rocatec). For each airborne-particle abrasion condition, the following post-airborne-particle abrasion treatments were used (n=10): (1) none; (2) adhesive Adper Single Bond 2; (3) silane RelyX Ceramic Primer. RelyX ARC resin cement was bonded to CP Ti surfaces. All specimens were thermally cycled before being tested in shear mode. Failure mode was determined. The best association was Rocatec plus silane. All groups showed 100% adhesive failure. There were combinations that promote higher SBS than the protocol recommended by the manufacturer of RelyX ARC.

Relevãncia do padrão de remodelamento ventricular no modelo de infarto do miocárdio em ratos

Background: The relevance of the remodeling pattern in the model of infarcted rats is not known. Objective: To analyze the presence of different patterns of remodeling in this model and its functional implications. Methods: Infarcted rats (n=47) have been divided according to the geometry pattern, analyzed by echocardiogram: normal (normal mass index and normal relative thickness), concentric remodeling (normal mass index and increased relative thickness), concentric hypertrophy (increased mass index and increased relative thickness) and eccentric hypertrophy (increased mass index and normal relative thickness). Data are median and interquartile range. Results: Infarcted rats showed only two of the four geometric patterns: normal pattern (15%) and eccentric hypertrophy - EH (85%). Groups of normal pattern and EH showed no differences in the values of fractional area change (Normal = 32.1-28.8 to 50.7; EH = 31.3-26.5 to 36.7; p = 0.343). Out of the infarcted animals, 34 (74%) had systolic dysfunction, detected by fractional area change. Considering these two geometry patterns, 77% of animals with eccentric hypertrophy and 57% with normal geometry presented systolic dysfunction (p=0.355). The relative wall thickness, the geometric patterns and the body mass index were not predictors of ventricular dysfunction (p>0.05). On the other hand, infarct size was a predictive factor for ventricular dysfunction in univariate analysis (p<0.001) and multivariate analysis (p = 0.004). Conclusion: Rats that underwent coronary occlusion showed two different patterns of remodeling, which do not constitute a predictor of ventricular dysfunction.

Calcium hydroxide intracanal dressing removal with different rotary instruments and irrigating solutions: A scanning electron microscopy study

This study evaluated the efficacy of 2 types of rotary instruments employed in association with sodium hypochlorite (NaOCl) or EDTA in removing calcium hydroxide (CH) residues from root canals dentin walls. Forty-two mandibular human incisors were instrumented with the ProTaper System up to F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA and filled with a CH intracanal dressing. After 7 days, the CH dressing was removed using 4 techniques: NiTi rotary instrument size 25, 0.06 taper (K3 Endo) and irrigation with 17% EDTA (Group 1), NiTi rotary F1 instrument (ProTaper) and irrigation with 17% EDTA (Group 2), NiTi rotary instrument size 25, 0.06 taper and irrigation with 2.5% NaOCl (Group 3) and NiTi rotary F1 instrument and irrigation with 2.5% NaOCl (Group 4). Two roots without intracanal dressing were used as negative controls. Teeth were evaluated by scanning electron microscopy, in the cervical and apical canal thirds. None of the techniques removed the CH dressing completely. In the apical and cervical thirds, F1 instrument was better than instrument size 25, 0.06 taper in removing CH residues (p<0.05), regardless of the final irrigating solution. No difference was found between the irrigating solutions in the groups of F1 instrument and of instrument size 25, 0.06 taper (p>0.05). The negative controls had no CH residues on the dentin walls. In conclusion, the ProTaper F1 instrument was better than K3 Endo instrument size 25, 0.06 taper in the removal of CH intracanal medication, regardless of irrigating solution used.

Bond strength of a composite resin to an adhesive luting cement

This study evaluated the influence of surface treatment on the shear bond strength of a composite resin (CR), previously submitted to the application of a temporary cement (TC), to an adhesive luting cement. Eight-four CR cylinders (5 mm diameter and 3 mm high) were fabricated and embedded in acrylic resin. The sets were divided into 6 groups (G1 to G6) (n=12). Groups 2 to 6 received a coat of TC. After 24 h, TC was removed and the CR surfaces received the following treatments: G2: ethanol; G3: rotary brush and pumice; G4: air-abrasion; G5: air-abrasion and adhesive system; G6: air-abrasion, acid etching and adhesive system. G1 (control) did not receive TC or any surface treatment. The sets were adapted to a matrix and received an increment of an adhesive luting cement. The specimens were subjected to the shear bond strength test. ANOVA and Tukey's tests showed that G3 (8.53 MPa) and G4 (8.63 MPa) differed significantly (p=0.001) from G1 (13.34 MPa). The highest mean shear bond strength values were found in G5 (14.78 MPa) and G6 (15.86 MPa). Air-abrasion of CR surface associated with an adhesive system provided an effective bond of the CR to the adhesive luting cement, regardless the pre-treatment with the phosphoric acid.

Dimensional alterations and solubility of new endodontic sealers

This study evaluated the dimensional alterations and the solubility of two experimental endodontic sealers based on Copaifera multijuga oil-resin (Biosealer) and castor oil bean cement (Poliquil), maintained in different storage solutions. Twenty specimens (3 mm diameter and 2 mm height) of each sealer were assigned to 2 groups (n=10) according to the storage solution: simulated tissue fluid (STF) or distilled water (DW). The specimens were stored in these solutions during 90 days, being removed every 30 days for weighting. The solutions were renewed every 15 days. The results were subjected to statistical analysis by Dunn's and Mann-Whitney tests (α=0.05). The solubility of Poliquil was higher in STF (38.4 ± 36.0) than in DW (28.4 ± 15.0), while Biosealer showed higher solubility in DW (34.61 ± 6.0) than in STF (18.59 ± 8.0). The storage solution influenced the behavior of sealers in relation to the weight variation (p=0.0001). Poliquil presented higher variation of weight independent of the solution (p=0.239). Biosealer also presented higher variation of weight regardless of the solution (p=0.0001). The solubility of Biosealer was different from that of Poliquil, but both sealers showed low solubility in STF. Under the tested conditions, neither of the materials were according to the ADA'S specification.

Correlation between oral health perception and clinical factors in a Brazilian community

Objective: The aim of this study was to analyse associations between self-perception of oral health and relevant clinical, personal and socio-demographic factors in a Brazilian community. Material And Methods: Urban adults living in a city in southern Brazil were interviewerd and examined. Individuals with acute pain and who needed multiple extractions of teeth were excluded. Self-perception and the Oral Health Impact Profile (OHIP-14) were applied to measure the impact of oral conditions on the quality of life. Socio-demographic and clinical indicators were also analysed. Results: The clinical examination revealed a high dental caries experience (DMFT = 18.9) and a high prevalence of periodontal disease. Oral condition was considered normal by 42% of respondents. The variables associated with the OHIP-14 were: education, age, self-assessment, dental caries and the DMFT index. Conclusions: Self-perception of oral health was associated with OHIP-14 and the clinical indicators had low influence in the self-perception. Therefore, the development of educational initiatives and preventive strategies for the adult population is recommended. © BASCD 2011.

pH-changes during intracoronal bleaching: An in vivo study

Objectives: This study aimed to measure pH changes during 14 days intracoronal bleaching with hydrogen peroxide/sodium perborate and carbamide peroxide/sodium perborate. Materials and methods: Twenty patients presenting endodontically treated central maxillary incisors with color alterations were divided in two groups (n = 10): Group CP + SP: 37% carbamide peroxide + sodium perborate paste; Group HP + SP: 30% hydrogen peroxide + sodium perborate paste. The pH values were measured using a digital microprocessor at different times: Baseline, 2, 7 and 14 days. Data were analyzed with two-way ANOVA followed by Tukey's test (α = 0.05). Results: ANOVA showed p < 0.00 which indicated significant difference between the groups. The mean values (± sd) and the results of the Tukey's test were: HP + SP/14 days-7.98 (±0.58)a; HP + SP/7 days-8.59 (±0.18)b; HP + SP/2 days-8.83 (±0.32)bc; HP + SP/Baseline-8.83 (±0.01)bc; CP + SP/Baseline-8.89 (±0.01)bc; CP + SP/14 days-9.11 (±0.58)cd; CP + SP/7 days-9.54 (±0.16)de; CP + SP/2 days-9.66 (±0.08) de. The group HP + SP resulted in significantly lower pH values compared with group CP + SP. Conclusion: It can be concluded that both associations showed alkaline pH values; however, there was significant reduction in the pH values of the 30% hydrogen peroxide associated with sodium perborate after 14 days. Clinical Significance: The association of hydrogen peroxide and carbamide peroxide with sodium perborate paste presented alkaline characteristics during the 14-day evaluated period. Thus, regarding pH changes, both associations can be considered safe as intracoronal bleaching agents.

Photoelastic comparison of single tooth implant-abutment-bone of platform switching vs conventional implant designs

Objectives: The maintenance and stability of peri-implantar soft tissue seem to be related to the crestal bone around the implant platform and different implant designs connections might affect this phenomenon. The aim of this study was to evaluate by photoelastic analysis the stress distribution in the cervical and apical site of implant-abutment interface of conventional implant joints (external hex, internal hex and cone morse) and compare to the novel platform switching design. Materials and methods: It was fabricated photoelastic models using five different implant-abutment connection, one set of external hex (Alvim Ti, Neodent, Curitiba, Brazil), one set of internal hex (Full Osseotite, Biomet 3i, Florida, USA), one cone morse set (Alvim CM, Neodent, Curitiba, Brazil), and two sets of internal hex plus platform switching concept (Alvim II Plus, Neodent, Curitiba, Brazil) (Certain Prevail, Biomet 3i, Florida, USA). These models were submitted to two compressive loads, axial from 20 kgf (load I) and another (load II), inclined 45° from 10 kgf. During the qualitative analysis, digital pictures were taken from a polariscope, for each load situation. For the quantitative analyses in both situations of load, the medium, minimum and maximum in MPa values of shear strain were determined in the cervical and apical site. The Kruskal-Wallis test was used to compare the results between the different systems and between cervical and apical site were compared using Mann-Whitney U test. Results: The results from qualitative analysis showed less concentration of strain in the cervical area to the internal hex plus platform switching (Certain Prevail), in both situation of load. The same results were get in the quantitative analysis, showing less stress concentrations around the implant Certain Prevail with internal hex plus the novel design (17.9 MPa to load I and 29.5 MPa to load II), however, without statistical significant difference between the systems. Conclusion: The minor stress concentration strongly suggest the use of platform switching design as a manner to prevent bone loss around the implant-abutment platform. Clinical Significance: From the result of this study its possible to make clinical decision for implant system which provides implant components with platform switching characteristics.

Effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching

Aim: This in vitro study evaluated the effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching. Materials and methods: A total of 50 extracted human premolars were prepared and filled with gutta-percha and endodontic sealer. The teeth were randomly divided into five groups according to the bleaching agents employed: (a) Sterile cotton pellet with distilled water (control group); (b) sodium perborate and distilled water; (c) sodium perborate and 10% carbamide peroxide; (d) sodium perborate and 35% hydrogen peroxide; (e) 35% hydrogen peroxide. The teeth were stored in vials containing distilled water and the pH values of the medium surrounding the teeth were analyzed. After 7-day storage, the bleaching agent was removed and replaced by calcium hydroxide, and the distilled water was changed, in which the teeth were kept stored for further 14 days. Measurement of pH of the external medium (distilled water) was performed 7 days after insertion of the bleaching agents, immediately, 7 and 14 days after insertion of the calcium hydroxide. Data were submitted to statistical analysis by the two-way ANOVA and Tukey,s test. Results: There were pH changes of the external medium at 7-day period after bleaching procedures. These results confirmed the diffusion of bleaching agents to the external medium. Conclusion: Calcium hydroxide increased the external medium pH and was effective for pH alkalinization after intracoronal bleaching. Clinical significance: Intracoronal bleaching of endodontically treated teeth may cause cervical root resorption. A possible explanation for this process is the passage of bleaching agents to the periodontal tissues yielding an inflammatory process. In an attempt to keep the neutrality of the periodontal pH, the calcium hydroxide has been recommended.Results of this study showed that this material should be always used after intracoronal bleaching.

Retention strength of cobalt-chromium vs nickel-chromium titanium vs Cp titanium in a cast framework association of removable partial overdenture

Aim: There is little information considering the framework association between cast clasps and attachments. The aim of this study was to evaluate the retention strength of frameworks match circumferential clasps and extra resilient attachment cast in three different alloys (cobalt-chromium, nickel-chromium titanium and commercially pure titanium), using two undercut (0.25 and 0.75 mm) and considering different period of time (0, 1/2, 1, 2, 3, 4 and 5 years). Methods: Using two metallic matrices, representing a partially edentulous mandibular right hemiarch with the first molar crown, canine root and without premolars, 60 frameworks were fabricated. Three groups (n = 20) of each metal were cast and each group was divided into two subgroups (n = 10), corresponding the molar undercut of 0.25 mm and 0.75 mm. The nylon male was positioned at the matrix and attached to the acrylic resin of the prosthetic base. The samples were subjected to an insertion and removal test under artificial saliva environment. Results: The data were analyzed and compared with ANOVAs and Tukey's test at 95% of probability. The groups cast in cobaltchromium and nickel-chromium-titanium had the highest mean retention strength (5.58 N and 6.36 N respectively) without significant difference between them, but statistically different from the group cast in commercially pure titanium, which had the lowest mean retention strength in all the periods (3.46 N). The association frameworks using nickel-chromium-titanium and cobalt-chromium could be used with 0.25 mm and 0.75 mm of undercut, but the titanium samples seems to decrease the retention strength, mainly in the 0.75 mm undercut. The circumferential clasps cast in commercially pure titanium used in 0.75 mm undercuts have a potential risk of fractures, especially after the 2nd year of use. Conclusion: This in vitro study showed that the framework association between cast clasp and an extra resilient attachment are suitable to the three metals evaluated, but strongly suggest extra care with commercially pure titanium in undercut of 0.75 mm. Clinical significance: Frameworks fabricated in Cp Ti tend to decrease in retentive strength over time and have a potential risk of fracture in less than 0.75 mm of undercut.

The influence of the flexibility of the chair seat on pressure peak and distribution of the contact area in individuals with cerebral palsy during the execution of a task

This study aimed to determine the influence of flexibility of the chair seat surface on the pressure peak and on the contact area during the execution of a task of handling an object on the seated position by individuals with spastic cerebral palsy. Ten individuals of both genders with diagnosis of spastic cerebral palsy, who had some control to voluntarily move the body and the upper limbs, participated in this study. Quantification of data was carried out in two experimental situations: (1) execution of a task of fitting with upper limbs, and with the individual placed on an adapted canvas seat; (2) execution of a task of fitting with the participant positioned on an adapted wooden seat. Data obtained were submitted to a non-parametric and descriptive statistical analysis using the Wilcoxon test. Results indicated that the use of canvas seat increased the contact area and decreased the pressure peak and the medio-lateral displacement of centre pressure on the seated posture. © 2011 Informa UK, Ltd.

Changes in facial morphology after adenotonsillectomy in mouth-breathing children

Background. Morphological and dentofacial alterations have been attributed to impaired respiratory function. Objective. To examine the influence of mouth breathing (MB) on children facial morphology before and after adenoidectomy or adenotonsillectomy. Methods. Thirty-three MB children who restored nasal breathing (NB) after surgery and 22 NB children were evaluated. Both groups were submitted to lateral cephalometry, at time 1 (T1) before and at time 2 (T2) 28months on average postoperatively. Results. Comparison between the MB and NB groups at T1 showed that mouth breathers had higher inclination of the mandibular plane; more obtuse gonial angle; dolichofacial morphology; and a decrease in the total and inferior posterior facial heights. Twenty-eight months after the MB surgical intervention, they still presented a dolichofacial morphologic pattern. During this period, MB altered the face growth direction and decreased their mandible plane inclination, with reduction in the SN.GoGn, PP.MP, SNGn, and ArGo.GoMe parameters as well as an increase in BaN.PtGn. Conclusion. After the MB rehabilitation, children between 3 and 6years old presented significant normalization in the mandibular growth direction, a decrease in the mandible inclination, and an increase in the posterior facial height. Instead, they still persisted with a dolichofacial pattern when compared with nasal breathers. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

Fracture resistance of composite resin cores with or without prefabricated posts over different substrates

The fracture resistance of endodontically treated teeth has been an obstacle to the durability of the remaining teeth and restorations. The aim of this study was to evaluate the fracture resistance of endodontically treated bovine and human teeth that were restored with either prefabricated metal posts, glass fiber posts, or composite resin cores. Statistical analysis revealed significant difference between different substrates, but there was no statistically significant difference between different types of intraradicular posts or in the interaction between substrate and post types. The intraradicular posts do not increase the fracture resistance of endodontically treated teeth. The metal posts presented more unfavorable fracture modes when compared to glass fiber posts and composite resin cores.