Prevalência de anodontia entre estudantes do 2O grau da cidade de São José dos Campos-Correlação dessa anomalia entre terceiros molares e outros órgão dentários.

The authors studied 201 school children form both sexes, aging 12 to 14 years, in order to identify anodontia, including in third molars. The results indicated a congenital absence of teeth in 24.37% of the examined children, distributed into 10.44% of boys and 13.93% of girls. Anodontia was observed concerning third molar teeth and other teeth, and the correlation was calculated by the total, sex, and hemiarch. The data were presented and discussed, and the results included several conclusions.

Effect of 2% chlorhexidine on microtensile bond strength of composite to dentin

Purpose: To evaluate the effect of 2% chlorhexidine on the microtensile bond strength of composite resin to dentin treated with three dentin bonding systems. Materials and Methods: Flat dentinal surfaces were prepared in 24 extracted human third molars. Teeth were randomly divided into 8 distinct experimental groups according to the adhesive applied (Prime & Bond NT, Single Bond and Clearfil SE Bond), the application (yes/no) of chlorhexidine, and the time point at which it was applied (before or after acid etching the dentin). Composite resin blocks were built up over treated surfaces, and teeth were then stored in water at 37°C for 24 h. Samples were thermocycled, stored under the same conditions, and then vertically sectioned, thus obtaining specimens with 1.0 ± 0.1 mm2 cross-sectional area. Specimens were stressed in tension at 0.5 mm/min crosshead speed. Bond strength results were evaluated using a one-way ANOVA (p < 0.05). The modes of failures were verified using optical microscopy. Dentin disks were obtained from 3 additional teeth treated in the same manner for observation under SEM. The most representative samples of fractured specimens were also observed under SEM. Results: No statistically significant differences of bond strength values were found between any groups. Failures occurred mainly within the bond; exclusively adhesive fractures (adhesive-dentin) were not observed. Conclusion: The 2% chlorhexidine solution, applied before or after acid etching of the dentin, did not interfere with the microtensile bond strength of composite resin to the dentin treated with Prime & Bond NT, Single Bond, or Clearfil SE Bond bonding systems.

Scanning electron microscope analysis of internal adaptation of materials used for pulp protection under composite resin restorations

Purpose: The aim of this study was to evaluate the interfacial microgap with different materials used for pulp protection. The null hypothesis tested was that the combination of calcium hydroxide, resin-modified glass ionomer, and dentin adhesive used as pulp protection in composite restorations would not result in a greater axial gap than that obtained with hybridization only. Materials and Methods: Standardized Class V preparations were performed in buccal and lingual surfaces of 60 caries-free, extracted human third molars. The prepared teeth were randomly assessed in six groups: (1) Single Bond (SB) (3M ESPE, St. Paul, MN, USA); (2) Life (LF) (Kerr Co., Romulus, MI, USA) + SB; (3) LF + Vitrebond (VT) (3M ESPE) + SB; (4) VT + SB; (5) SB + VT; (6) SB + VT + SB. They were restored with microhybrid composite resin Filtek Z250 (3M ESPE), according to the manufacturer's instructions. However, to groups 5 and 6, the dentin bonding adhesive was applied prior to the resin-modified glass ionomer. The specimens were then thermocycled, cross-sectioned through the center of the restoration, fixed, and processed for scanning electron microscopy. The specimens were mounted on stubs and sputter coated. The internal adaptation of the materials to the axial wall was analyzed under SEM with × 1,000 magnification. Results: The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, p ≤ .05). The null hypothesis was rejected. Calcium hydroxide and resin-modified glass ionomer applied alone or in conjunction with each other (p < .001) resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration. ©2005 BC Decker Inc.

Cutting characteristics of dental diamond burs made with CVD technology

The aim of this study was to determine the cutting ability of chemical vapor deposition (CVD) diamond burs coupled to an ultrasonic dental unit handpiece for minimally invasive cavity preparation. One standard cavity was prepared on the mesial and distal surfaces of 40 extracted human third molars either with cylindrical or with spherical CVD burs. The cutting ability was compared regarding type of substrate (enamel and dentin) and direction of handpiece motion. The morphological characteristics, width and depth of the cavities were analyzed and measured using scanning electron micrographs. Statistical analysis using the Kruskal-Wallis test (p < 0.05) revealed that the width and depth of the cavities were significantly greater when they were prepared on dentin. Wider cavities were prepared when the cylindrical CVD bur was used, and deeper cavities resulted from preparation with the spherical CVD bur. The direction of handpiece motion did not influence the size of the cavities, and the CVD burs produced precise and conservative cutting.

Fatigue resistance of the bond of a glass-infiltrated alumina ceramic to human dentin

Purpose: To evaluate the fatigue resistance of the bond between dentin and glass-infiltrated alumina ceramic, using different luting protocols. Materials and Methods: The null hypothesis is that the fatigue resistance varies with the luting strategy. Forty blocks of In-Ceram Alumina were prepared, and one surface of each block was abraded with 110-μm aluminum oxide particles. Then, the blocks were luted to flat dentin surfaces of 40 human third molars, using 4 different luting strategies (luting system [LS]/ceramic surface conditioning [CSC]) (n=10): (G1) [LS] RelyX-Unicem/[CSC] airborne abrasion with 110-μm Al2O3 particles; (G2) [LS] One-Step + Duo-Link (bis-GMA-based resin)/[CSC] etching with 4% hydrofluoric acid + silane agent; (G3) [LS] ED-Primer + Panavia F (MDP-based resin)/[CSC] Al2O 3; (G4) [LS] Scotchbond1+RelyX-ARC (bis-GMA-based resin)/[CSC] chairside tribochemical silica coating (air abrasion with 30-μm SiO x particles + silane). After 24 h of water storage at 37°C, the specimens were subjected to 106 fatigue cycles in shear with a sinusoidal load (0 to 21 N, 8 Hz frequency, 37°C water). A fatigue survivor score was given, considering the number of the fatigue cycles until fracture. The failure modes of failed specimens were observed in a SEM. Results: G3 (score = 5.9, 1 failure) and G4 (score = 6, no failures) were statistically similar (p = 0.33) and had significantly higher fatigue resistance than G1 (score = 3.9, 5 failures) and G2 (score = 3.7, 6 failures) (p < 0.03). SEM analysis of fractured specimens of G1 and G2 showed that almost all the failures were between ceramic and cement. Conclusion: The MDP-based resin cement + sandblasting with Al2O3 particles (G3) and bis-GMA-based resin cement + tribochemical silica coating (G4), both using the respective dentin bonding systems, were the best luting protocols for the alumina ceramic. The null hypothesis was confirmed.

Effect of dentinal surface preparation on bond strength of self-etching adhesive systems

The aim of this study was to evaluate the effects of dentin surface treatments on the tensile bond strength (TBS) of the self-etching primer Clearfil SE Bond (CSE) and the one-step self-etching One-Up Bond F (OUB). The exposed flat dentin surfaces of twenty-four sound third molars were prepared with diamond bur at high-speed, carbide bur at low-speed or wet ground with #600 grit SiC paper. The adhesive systems were applied to the dentin surfaces and light-cured according to the manufacturers' instructions. A 6-mm high composite crown was incrementally built-up and each increment was light-cured for 40 seconds. After being stored in water (37°C/24 h), the samples were serially sectioned parallel to the long axis, forming beams (n = 20) with a cross-sectional area of approximately 0.8 mm 2. The specimens were tested in a Universal Testing Machine at 0.5 mm/min. The cross-sectional area was measured and the results (MPa) were analyzed by two-way ANOVA and Tukey Test (p < 0.05). Overall, the groups treated with CSE exhibited the highest TBS for all surface treatments. Dentin surfaces prepared with carbide bur at low speed reduced TBS in the CSE group; however, OUB was not affected by surface treatments. The effect of surface abrasive methods on TBS was material-dependent.

Tensile bond strength of self-etching versus total-etching adhesive systems under different dentinal substrate conditions

The use of acid etchants to produce surface demineralization and collagen network exposure, allowing adhesive monomers interdiffusion and consequently the formation of a hybrid layer, has been considered the most efficient mechanism of dentin bonding. The aim of this study was to compare the tensile bond strength to dentin of three adhesive systems, two self-etching ones (Clearfil SE Bond - CSEB and One Up Bond F - OUBF) and one total-etching one (Single Bond - SB), under three dentinal substrate conditions (wet, dry and re-wet). Ninety human, freshly extracted third molars were sectioned at the occlusal surface to remove enamel and to form a flat dentin wall. The specimens were restored with composite resin (Filtek Z250) and submitted to tensile bond strength testing (TBS) in an MTS 810. The data were submitted to two-way ANOVA and Tukey's test (p = 0.05). Wet dentin presented the highest TBS values for SB and CSEB. Dry dentin and re-wet produced significantly lower TBS values when using SB. OUBF was not affected by the different conditions of the dentin substrate, producing similar TBS values regardless of the surface pretreatments.

In vivo preservation of the hybrid layer by chlorhexidine

Host-derived proteases have been reported to degrade the collagen matrix of incompletely-resin-infiltrated dentin. This study tested the hypothesis that interfacial degradation of resin-dentin bonds may be prevented or delayed by the application of chlorhexidine (CHX), a matrix metalloproteinase inhibitor, to dentin after phosphoric acid-etching. Contralateral pairs of resin-bonded Class I restorations in non-carious third molars were kept under intra-oral function for 14 months. Preservation of resin-dentin bonds was assessed by microtensile bond strength tests and TEM examination. In vivo bond strength remained stable in the CHX-treated specimens, while bond strength decreased significantly in control teeth. Resin-infiltrated dentin in CHX-treated specimens exhibited normal structural integrity of the collagen network. Conversely, progressive disintegration of the fibrillar network was identified in control specimens. Auto-degradation of collagen matrices can occur in resin-infiltrated dentin, but may be prevented by the application of a synthetic protease inhibitor, such as chlorhexidine.

Influence of resin composite insertion technique in preparations with a high C-factor

Objective: To evaluate the marginal microleakage in enamel and dentin/cementum walls in preparations with a high C-factor, using 3 resin composite insertion techniques. The null hypothesis was that there is no difference among the 3 resin composite insertion techniques. Method and Materials: Standardized Class 5 cavities were prepared in the lingual and buccal aspects of 30 caries-free, extracted third molars. The prepared teeth were randomly assigned to 3 groups: (1) oblique incremental placement technique, (2) horizontal incremental placement technique, and (3) bulk insertion (single increment). The preparations were restored with a 1-bottle adhesive (Single Bond, 3M ESPE) and microhybrid resin composite (Z100, 3M ESPE). Specimens were isolated with nail varnish except for a 2-mm-wide rim around the restoration and thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50 wt% silver nitrate for 24 hours, followed by 8 hours in a photo-developing solution and evaluated for microleakage using an ordinal scale of 0 to 4. The microleakage scores obtained from occlusal and gingival walls were analyzed with Wilcoxon and Kruskal-Wallis nonparametric tests. Results: The null hypothesis was accepted. The horizontal incremental placement technique, the oblique incremental technique, and bulk insertion resulted in statistically similar enamel and dentin microleakage scores. Conclusion: Neither the incremental techniques nor the bulk placement technique were capable of eliminating the marginal microleakage in preparations with a high C-factor.

Influence of surface sealants on microleakage of composite resin restorations

Purpose: The purpose of this study was to verify the influence of surface sealants and dentin adhesive systems on the microleakage of composite restorations. Methods: Class V cavities were made on the buccal faces of 100 permanent third molars and restored with Z250. After 24 hours, they were submitted to polishing and finishing processes. The teeth were divided into groups according to the sealant agent: group 1 - Single Bond; group 2 - Opti Bond Solo Plus; group 3 - Fortify; group 4 - Fortify Plus; and group 5 - control without sealant. The analysis of immediate microleakage was performed in 10 restorations from each group, soon after the sealing. The other 10 specimens from each group were submitted to tooth-brushing and thermal cycles. The teeth were isolated and immersed in 2% methylene blue solution, washed in tap water, and sectioned in the buccolingual direction. The percentage of marginal leakage was calculated using an image analysis program, and results were submitted to analysis of variance and Tukey's test. Results: All the sealed groups demonstrated lower microleakage values compared to the control group. Group 3, sealed with Fortify, presented the lowest mean microleakage values. Conclusion: The application of surface sealants effectively decreased the microleakage in composite resin restorations.

Effect of ultrasonic instrumentation on the bond strength of crowns cemented with zinc phosphate cement to natural teeth. An in vitro study

Several studies have reported the benefits of sonic and/or ultrasonic instrumentation for root debridement, with most of them focusing on changes in periodontal clinical parameters. The present study investigated possible alterations in the tensile bond strength of crowns cemented with zinc phosphate cement to natural teeth after ultrasonic instrumentation. Forty recently extracted intact human third molars were selected, cleaned and stored in physiologic serum at 4°C. They received standard preparations, at a 16° convergence angle, and AgPd alloy crowns. The crowns were cemented with zinc phosphate cement and then divided into four groups of 10 teeth each. Each group was then subdivided into two subgroups, with one of the subgroups being submitted to 5,000 thermal cycles ranging from 55 ± 2 to 5 ± 2°C, while the other was not. Each group was submitted to ultrasonic instrumentation for different periods of time: group 1 - 0 min (control), group 2 - 5 min, group 3 - 10 min, and group 4 - 15 min. Tensile bond strength tests were performed with an Instron testing machine (model 4310). Statistical analysis was performed using ANOVA and Tukey's test at the 5% level of significance. A significant reduction in the tensile bond strength of crowns cemented with zinc phosphate and submitted to thermal cycles was observed at 15 min (196.75 N versus 0 min = 452.01 N, 5 min = 444.23 N and 10 min = 470.85 N). Thermal cycling and ultrasonic instrumentation for 15 min caused a significant reduction in tensile bond strength (p < .05).

Influência da contaminação da dentina por cimentos temporários na resistência da união de sistemas adesivos

Objective: The aim of this study was to assess the bond strength of adhesive systems to dentin contaminated by temporary cements with or without eugenol. Method: Flat dentin surfaces were obtained from twenty-four human third molars. With exception of the control group (n=8), the surfaces were covered with Interim Restorative Material (Caulk Dentsplay, Milford, DE, USA) or Cavit (3M ESPE, St. Paul, MN, USA) and kept in an oven at 37°C for seven days. After removing the cements, the adhesive systems Adper Single Bond (3M ESPE, St. Paul, MN, USA) or Clearfil SE Bond (Kuraray Co. Ltd., Osaka, Japan) were applied in accordance with the manufacturers' recommendations, and then the crowns were constructed in of resin composite. The teeth were sectioned into specimens with a cross-sectional bond area of 0.81mm2, which were submitted to microtensile testing in a mechanical test machine at an actuator speed of 0.5mm/min. The data were analyzed by t- and ANOVA tests, complemented by Tukey tests (α=0.05). Results: For Adper Single Bond (3M ESPE, St. Paul, MN, USA), bond strength did not differ statistically (p>0.05) for all the experimental conditions. For Clearfil SE Bond (Kuraray Co. Ltd., Osaka, Japan), only the Interim Restorative Material (Caulk Dentsplay, Milford, DE, USA) Group showed significantly lower bond strength (30.1 ± 13.8 MPa) in comparison with the other groups; control (38.9 ± 13.5 MPa) and Cavit (3M ESPE, St. Paul, MN, USA) (42.1 ± 11.0 MPa), which showed no significant difference between them. Conclusion: It was concluded that the previous covering of dentin with temporary cement containing eugenol had a deleterious effect on the adhesive performance of the self-etching system only.

Transformação cística como consequência de terceiro molar inferior incluso

The permanence of impacted third molar in the jaws can cause many pathological alterations, amongst them the appearance of odontogenic cysts. The paradental cyst appearance and evolution next to a mandibular included third molar was diagnosised in radiograph routine follow-up, and its evolution and treatment are described. Are discussed the aspects related with the preventive removal to the impacted third molars and the necessity to institution a plan of treatment based in clinical history and radiograph in order to establish a preventive protocol the alterations caused by these impactions. The indication of extraction of impacted third enclosed can be a way to preventing the appearance of these and otherspathologies associates to these lesions.

In vitro evaluation of the effect of dietary acids and toothbrushing on human root dentin permeability

OBJECTIVES: The purpose of this in vitro study was to quantify the alterations in human root dentin permeability after exposure to dietary acids and to evaluate the effect of toothbrushing after acid application. METHOD AND MATERIALS: Extracted human third molars had their crowns sectioned above the CEJ, pulp tissue removed, and cervical root dentin exposed using a high-speed bur (approximately 1 mm in depth of substance loss). From each root fragment, one specimen was prepared. A total of 25 specimens were used and distributed randomly into five groups. The specimens were attached to a hydraulic pressure apparatus to evaluate the alterations of root dentin permeability after exposure to different acids. Dentin permeability was measured after the following sequential steps: (1) treatment with EDTA for 3 minutes to obtain the maximum permeability; (2) root planing to create a smear layer; (3) exposure to different acidic substances for 5 minutes (vinegar, cola drink, lemon juice, white wine, and orange juice); and (4) brushing for 3 minutes. RESULTS: All acidic substances increased dentin permeability after root planing. Lemon juice produced higher values for permeability when compared to the other substances (P = .009); moreover, orange juice showed similar results (P < .02) except when compared to vinegar (P = .12). Brushing right after acid exposure significantly reduced dentin permeability except in the vinegar group (P = .07). CONCLUSION: Under the experimental conditions, dietary acids increased root dentin permeability, and immediate brushing reduced permeability levels.

Bilateral lower second molar impaction in teenagers: An emergent problem

The frequency of simultaneously impacted second and third molars in teenagers is increasing and becoming a common occurrence in adolescent oral surgery practice. The traditional treatment is the removal of the third molar by conventional access but repositioning of the surgical flap to the distal face of the first molar can predispose to complications such as pericoronitis and delayed healing of the attached gingiva. We present a case in which we use the germectomy approach to remove the impacted third molar for the eruption of the second molar through a vestibular incision. This incision offers excellent bone exposure and exit route for the third molar without disturbing the gingiva attached architecture on the distal face of the first molar providing good healing environment.