Bone apposition and surface treatment in dental implants: histomorphometric pilot evaluation in rabbits

The surface of dental implants is an important factor for osseointegration process and different methods of surface treatment have been described. Objective: To investigate the bone apposition in implant surface treated with sandblasting and acid-etching. Material and methods: Ten rabbits were selected and received one implant treated with method I in the left tibia and one implant treated with method II in the right tibia. Then, twenty implants were divided in two groups, according to methods of sandblasting and acid-etching (method I and method II). After 7, 14, 30, 45 and 60 days, tibias were retrieved and submitted to histotechnical procedures. The percentages of bone–implant contact (BIC) and bone area between threads (BABT) were determined throughout histomorphometric analysis and bone apposition was detected in implants of both groups. Results: In BABT measurements, an increase was observed after 45 and 60 days in the method II, compared to method I and no differences were found after 7, 14 and 30 days. In BIC measurements, an increase was detected with method II at 45 days when compared to method I. No differences between groups in BIC values were observed after 7, 14, 30 and 60 days. Conclusion: Our data demonstrated that implants treated with the method II presented increase in the contact between bone and implant after 45 days compared to method I. Moreover, with concern to bone area between threads, it was observed an increased in the method II after 45 and 60 days. However, both groups can be successfully used as a therapeutic strategy to rehabilitation of edentulous patients. Then, further experiments are needed to evaluate, in depth, the putative differential role of each surface treatment.

Efeitos de diferentes sistemas de clareamento dental sobre a rugosidade e morfologia superficial do esmalte e de uma resina composta restauradora

The aim of this study was to evaluate and compare the roughness and superficial morphology of enamel and a composite restorative resin after different bleaching techniques application. Material and Methods: Bovine incisors were selected and standardized cavities were prepared on the buccal surface, which were restored with composite resin. The teeth were distributed according to the following treatments: G1- bleaching with 10% carbamide peroxide (CP); G2 - bleaching with 38% hydrogen peroxide (HP); and G3 - bleaching with 38% of HP associated to light irradiation. For G1, the bleaching gel was applied for 8 hours daily during 21 days. For G2 and G3, 3 sessions were performed, consisting of 3 applications of 15 minutes each, with 7 days of intervals between the sessions. For G3, the LED (470nm) light was used to activate the bleaching agent for 6 minutes. The surface of enamel and composite resin were evaluated before and after the bleaching procedures using a roughness tester and an atomic force microscope. Results: The results showed significant differences in surface roughness of enamel after bleaching only for G1 (Wilcoxon, p<0.05). For composite resin, neither group showed a statistical difference compared to control (Mann-Whitney, p>0.05). Conclusion: It was concluded that the increase in the roughness of enamel occurred only after bleaching therapy using a gel with 10% of CP. The bleaching procedures evaluated in this investigation did not increase the roughness or cause changes in the superficial morphology of the composite resin.

Estudo prospectivo sobre a utilização de próteses totais implantossuportadas em pacientes edêntulos

The objective of this study was to evaluate the impact of replacing conventional mandibular complete dentures by complete fixed dentures on the oral health-related quality of life and kinesiographic parameters of maxillary edentulous patients. Material and Methods: edentulous patients (n = 16) received one set of new complete dentures and after the intraoral adjustments and adaptation period (30 days), the Brazilian version of Oral Health Impact Profile for assessing edentulous subjects (Ohip-Edent) was used to evaluate the oral health-related quality of life (OHQOL) of the participants. Additionally, the kinesiograph instrument K6-I (Myotronics Research Inc., Seattle, WA) was used to record opening and closure range of movement, mandibular movement, and the pattern of maxillary complete denture movement on chewing. Afterwards, the patients had their mandibular complete dentures replaced by a complete fixed denture and the same evaluation protocol was performed after 3 and 6 months. Ohip-Edent responses were analyzed using Wilcoxon's test for repeated measures (α = .05) and Kinesiographic data using the Student´s t test (α = .05). Results: The Ohip-Edent showed an improvement of general oral health-related quality of life after 3 and 6 months of the treatment with complete fixed dentures. Kinesiographic recordings revealed a significant increase on maximum mandibular movements of vertical opening and no differences for the movement of the maxillary complete denture on chewing after treatment with complete fixed dentures was observed. Conclusion: the installation of complete fixed dentures improved the OHQOL and changed mandibular movements, with increases in vertical amplitude of maximal opening.

Effect of different light-curing techniques on hardness of a microhybrid dental composite resin

Coordenação de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Effect of two formulations of 10% sodium ascorbate on fracture resistance of endodontically treated tooth submitted to dental bleaching with hydrogen peroxide associated titanium dioxide nanoparticles

Purpose: This study evaluated the effect of 10% sodium ascorbate (10SA), in gel (10SAg) or aqueous solution (10SAs) formulations, on fracture resistance of endodontically treated tooth submitted to dental bleaching procedures with 15% hydrogen peroxide associated with titanium dioxide (15HP-TiO2) nanoparticles and photoactivated by LED-laser. Material and methods: Forty maxillary premolars were endodontically-treated and embedded in acrylic resin up to the cement-enamel junction. The specimens were divided into four groups (n=10): G1 (negative control): no bleaching, coronal access restored with composite resin; G2 (positive control): three dental bleaching sessions using 15HP-TiO2 and LED-laser photoactivation and restored with composite resin (positive control); G3 (10SAg): similar procedures to G2, but applied 10SA, in gel formulation, for 24 hours before restoration; G4 (10SAs): similar procedures to G3, but applied 10SA, in aqueous solution formulation. The 15HP-TiO2 was applied on buccal and lingual surfaces of the crown tooth and inside the pulp chamber and photoactivated by LED-laser. Between each bleaching session, the teeth were maintained in artificial saliva, at 37oC, for 7 days. In sequence, the teeth were submitted to fracture resistance testing using an eletromechanical machine test. The data was analyzed using Kruskal Wallis test (p = 0.05) Results: There are no differences significant among the groups in relation to fracture resistance of endodontically treated teeth (p>0.05). Conclusions: The use of 10% sodium ascorbate, in gel or aqueous solution formulations, did not interfered on the fracture resistance teeth after dental bleaching using 15HP-TiO2 and LED-laser photoactivation.

Repercussões endodônticas dos procedimentos clareadores

Tooth bleaching is a treatment modality that raises great interest, due to the important role played by aesthetics in current life style. To perform such procedure, nowadays, there are several bleaching substances at several concentrations, as well as, diverse clinical techniques. When suggesting this procedure, the dentist should take into consideration several factors related to the patient to determine which will be the most appropriate technique/material combination for solving the clinical problem. The procedure indication should not only be based on the expectations exhibited by the patient, but also on respecting the biological principles to maintain the integrity of both the endodontic and periodontal tissues.

Impacto da saúde bucal na qualidade de vida de pacientes maiores de 50 anos de duas instituições públicas do município de Araraquara-SP

Introduction: Oral health can affect quality of life, and the OHIP-14 index (Oral Health Impact Profile) is useful for evaluating this impact. Objective: to investigate the impact of oral health conditions on the quality of life of patients over  50  years, assessing, initially, the consistency of the short form of the Oral Health Impact Profile index (OHIP-14). Material and method: A cross-sectional study was performed among 149 patients of two public institutions for routine dental (UNESP) and medical practice (Municipal). They were interviewed using the OHIP-14 formulary, assessing its internal consistency (Cronbach´s alpha coefficient) and the OHIP-mean (additive method). The patients were distributed according to sex, age, and education level. The comparisons of interest were made using Student´s t test at a 5% level of significance. Result: A total of consecutive patients (n = 149) participated of this study (87% response rate). Cronbach´s alpha coefficient was 0.78, denoting a good consistency of the OHIP index. The OHIP mean was 4.98. The most prevalently affected OHIP domains were dimensions of physical pain: painful aching (11.40%) and uncomfortable eating foods (21.50%). There was non-significant difference (p > 0.05) between the mean OHIP value in relation to each of gender, age, and education level. Conclusion: The OHIP-14 is a reliable instrument of assessing oral health-related quality of life, and among patients under routine practice, it was found a low impact of oral conditions on their quality of life in the studied institutions (UNESP and Municipal).

Roughness and morphology of composites: influence of type of material, fluoride solution, and time

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Chemical and morphological features of dental composite resin: influence of light curing units and immersion media

Aims: The study evaluated the influence of light curing units and immersionmedia on superficial morphology and chemistry of the nanofilled composite resin Supreme XT (3M)through the EDX analysis and SEM evaluation. Light curing units with different power densitiesand mode of application used were XL 3000 (480 mW/cm2), Jet Lite 4000 Plus (1230mW/cm2), andUltralume Led 5 (790 mW/cm2) and immersion media were artificial saliva, Coke1, tea and coffee,totaling 12 experimental groups. Specimens (10 mm 3 2 mm) were immersed in each respectivesolution for 5 min, three times a day, during 60 days and stored in artificial saliva at 378C 6 18Cbetween immersion periods. Topography and chemical analysis was qualitative. Findings: Groupsimmersed in artificial saliva, showed homogeneous degradation of matrix and deposition of calciumat the material surface. Regarding coffee, there was a reasonable chemical degradation with loss ofload particles and deposition of ions. For tea, superficial degradation occurred in specific areaswith deposition of calcium, carbon, potassium and phosphorus. For Coke1, excessive matrix degra-dation and loss of load particles with deposition of calcium, sodium, and potassium. Conclusion:Light curing units did not influence the superficial morphology of composite resin tested, but theimmersion beverages did. Coke1affected material’s surface more than did the other tested drinks.Microsc. Res. Tech. 73:176–181, 2010.

A new calcium silicate-based material (Biodentine) for filling radicular perforation in an endodontic-periodontal lesion: a case report

This case report presents an apical radicular perforation management using new calcium silicate-based cement (Biodentine) in a combined endodontic-periodontal lesion. The presence of apical radicular perforation may interfere in the endodontic treatment prognosis. Radicular perforation filling with bioactive cement through endodontic surgery is a possible treatment. This study presents an apical radicular perforation with periodontal involvement, due to alveolar bone loss on the buccal radicular surface from an incorrect intracanal preparation for the fiber post placing. The chosen alternative was a periapical surgery, the perforation was filled with a silicate and calcium chloride bioactive cement (Biodentine; Septodont, Saint-Maur-des-Fosses Cedex, France), and the radicular surface was etched with citric acid, because the access from root canal was impossible. The follow-up was for 8 months, through clinical and radiographic analysis. At the end of the follow-up, radiographic analyses showed the bone healing, and no clinical changes in periodontal probing depth, gingival recession, and the height of the interproximal mesial and distal papillae were observed. The root perforation treatment has a difficult management, especially when the dental root has a simultaneous periodontal commitment. The Biodentine proves to be a promising material for use in these situations.

Individual and contextual factors related to dental caries in underprivileged Brazilian adolescents

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

Spectrophotometric evaluation of dental bleaching under orthodontic bracket in enamel and dentin

Aware of the diffusion capacity of bleaching in the dental tissues, many orthodontists are subjecting their patients to dental bleaching during orthodontic treatment for esthetic purposes or to anticipate the exchange of esthetic restorations after the orthodontic treatment. For this purpose specific products have been developed in pre-loaded whitening trays designed to fit over and around brackets and wires, with clinical efficacy proven. Objective: The objective of this study was to evaluate, through spectrophotometric reflectance, the effectiveness of dental bleaching under orthodontic bracket. Material and Methods: Thirty-two bovine incisors crown blocks of 8 mm x 8 mm height lengths were used. Staining of tooth blocks with black tea was performed for six days. They were distributed randomly into 4 groups (1-home bleaching with bracket, 2- home bleaching without bracket, 3- office bleaching with bracket, 4 office bleaching without bracket). The color evaluation was performed (CIE L * a * b *) using color reflectance spectrophotometer. Metal brackets were bonded in groups 1 and 3. The groups 1 and 2 samples were subjected to the carbamide peroxide at 15%, 4 hours daily for 21 days. Groups 3 and 4 were subjected to 3 in-office bleaching treatment sessions, hydrogen peroxide 38%. After removal of the brackets, the second color evaluation was performed in tooth block, difference between the area under the bracket and around it, and after 7 days to verified color stability. Data analysis was performed using the paired t-test and two-way variance analysis and Tukey’s. Results: The home bleaching technique proved to be more effective compared to the office bleaching. There was a significant difference between the margin and center color values of the specimens that were subjected to bracket bonding. Conclusions: The bracket bond presence affected the effectiveness of both the home and office bleaching treatments.

Burnout in dental students: effectiveness of different methods

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of moisture on dental enamel in the interaction of two orthodontic bonding systems

OBJECTIVE: The purpose of this study was to assess by means of scanning electron microscopy (SEM) the remaining adhesive interface after debonding orthodontic attachments bonded to bovine teeth with the use of hydrophilic and hydrophobic primers under different dental substrate moisture conditions. MATERIAL AND METHODS: Twenty mandibular incisors were divided into four groups (n=5). In Group I, bracket bonding was performed with Transbond MIP hydrophilic primer and Transbond XT adhesive paste applied to moist substrate, and in Group II a bonding system comprising Transbond XT hydrophobic primer and adhesive paste was applied to moist substrate. Brackets were bonded to the specimens in Groups III and IV using the same adhesive systems, but on dry dental enamel. The images were qualitatively assessed by SEM. RESULTS: The absence of moisture in etched enamel enabled better interaction between bonding materials and the adamantine structure. The hydrophobic primer achieved the worst micromechanical interlocking results when applied to a moist dental structure, whereas the hydrophilic system proved versatile, yielding acceptable results in moist conditions and excellent interaction in the absence of contamination. CONCLUSION: The authors assert that the best condition for the application of primers to dental enamel occurs in the absence of moisture.

Quality of life and satisfaction of patients wearing implant-supported fixed partial denture: a cross-sectional survey of patients from Aracatuba city, Brazil

ObjectivesThe aim of this study was to evaluate the quality of life and satisfaction of patients wearing implant-supported fixed partial dentures.Materials &methodsA total of 106 patients were selected and submitted to clinical examination and collection of the demographic data for evaluation of the implant-supported fixed dentures conditions. All participants agreed to answer to the Oral Health Impact Profile (OHIP-EDENT) questionnaire and another questionnaire about satisfaction with the implant-supported prostheses. The patients were classified into the following three groups for statistical analysis: patients wearing splinted implant-supported prosthesis (E), patients wearing single implant-supported prosthesis (U), and patients wearing single implant-supported prosthesis associated with splinted prosthesis (E+U). Kruskal-Wallis test was used to compare the answers between the groups, and a logistic regression model was measured to verify the relation between variables of the patients and the questionaries'items.ResultsThere were significant differences among groups (P=0.006) for discomfort during surgery itself of the satisfaction questionnaire. The marital status, groups, and hygiene condition were significant mainly for physical pain item.ConclusionsIt was concluded that the patients presented high level of satisfaction and quality of life for the most of the items evaluated as well as the groups showed similar results.