Radiopacity of restorative materials using digital images

The radiopacity of esthetic restorative materials has been established as an important requirement, improving the radiographic diagnosis. The aim of this study was to evaluate the radiopacity of six restorative materials using a direct digital image system, comparing them to the dental tissues (enamel-dentin), expressed as equivalent thickness of aluminum (millimeters of aluminum). Five specimens of each material were made. Three 2-mm thick longitudinal sections were cut from an intact extracted permanent molar tooth (including enamel and dentin). An aluminum step wedge with 9 steps was used. The samples of different materials were placed on a phosphor plate together with a tooth section, aluminum step wedge and metal code letter, and were exposed using a dental x-ray unit. Five measurements of radiographic density were obtained from each image of each item assessed (restorative material, enamel, dentin, each step of the aluminum step wedge) and the mean of these values was calculated. Radiopacity values were subsequently calculated as equivalents of aluminum thickness. Analysis of variance (ANOVA) indicated significant differences in radiopacity values among the materials (P<0.0001). The radiopacity values of the restorative materials evaluated were, in decreasing order: TPH, F2000, Synergy, Prisma Flow, Degufill, Luxat. Only Luxat had significantly lower radiopacity values than dentin. One material (Degufill) had similar radiopacity values to enamel and four (TPH, F2000, Synergy and Prisma Flow) had significantly higher radiopacity values than enamel. In conclusion, to assess the adequacy of posterior composite restorations it is important that the restorative material to be used has enough radiopacity, in order to be easily distinguished from the tooth structure in the radiographic image. Knowledge on the radiopacity of different materials helps professionals to select the most suitable material, along with other properties such as biocompatibility, adhesion and esthetic.

Surface roughness of glass ionomer cements indicated for atraumatic restorative treatment (ART)

The purpose of this study was to evaluate the surface roughness of four conventional chemically cured glass ionomer cements (Fuji IX, Ketac Molar, Vidrion R and Vitromolar) commonly used in atraumatic restorative treatment (ART) immediately after material preparation. Twenty specimens of each glass ionomer cement were fabricated and surface roughness was measured after material setting. The specimens were further examined under scanning electron microscopy. Data were analyzed statistically by Kruskal-Wallis test and Mann-Whitney test at 5% significance level. Two-by-two comparisons showed statistically significant difference (p<0.05) between all materials, except for Ketac Molar and Vidrion R, which had statically similar results (p>0.05). Regarding their results of surface roughness, the materials can be presented in a crescent order, as follows: Ketac Molar < Vidrion R < Fuji IX < Vitromolar. In conclusion, from the tested glass ionomer cements, Fuji IX, Ketac Molar and Vidrion R presented acceptable surface roughness after setting reaction while Vitromolar showed remarkably higher surface roughness.

Microhardness and fluoride release of restorative materials in different storage media

This study evaluated the surface microhardness and fluoride release of 5 restorative materials - Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom and Fluorofil - in two storage media: distilled/deionized water and a pH-cycling (pH 4.6). Twelve specimens of each material, were fabricated and the initial surface microhardness (ISM) was determined in a Shimadzu HMV-2000 microhardness tester (static load Knoop). The specimens were submitted to 6- or 18-h cycles in the tested media. The solutions were refreshed at the end of each cycle. All solutions were stored for further analysis. After 15-day storage, the final surface microhardness (FSM) and fluoride release were measured. Fluoride dose was measured with a fluoride-specific electrode (Orion 9609-BN) and digital ion analyzer (Orion 720 A). The variables ISM, FSM and fluoride release were analyzed statistically by analysis of variance and Tukey's test (p<0.05). There was significant difference in FSM between the storage media for Vitremer (pH 4.6 = 40.2 ± 1.5; water = 42.6 ± 1.4), Ketac-Fil Plus (pH 4.6 = 73.4 ± 2.7; water = 58.2 ± 1.3) and Fluorofil (pH 4.6 = 44.3 ± 1.8; water = 38.4 ± 1.0). Ketac-Fil Plus (9.9 ± 18.0) and Fluorofil (4.4 ± 1.3) presented higher fluoride release in water, whereas Vitremer (7.4 ± 7.1), Fuji II LC (5.7 ± 4.7) and Freedom (2.1 ± 1.7) had higher fluoride release at pH 4.6. Microhardness and fluoride release of the tested restorative materials varied according to the storage medium.

How to drag with a worn-out mouse? Searching for social justice through collaboration

We consider what a concern for social justice in terms of social inclusion might mean for teacher education, both practising and prospective, with particular reference to the use of information and communication technology (ICT) in mathematics education taking place at a borderland school. Our discussion proceeds through the following steps: (1) We explore what a borderland position might denote to address what social inclusion might mean. (2) We consider the significance of mathematics education and the use of ICT for processes of social inclusion. (3) We briefly refer to the Interlink Network, as many of our observations emerge as reflections on this project. (4) We present different issues that will be of particular importance with respect to teacher education if we want to establish a mathematics education for social inclusion. These issues concern moving away from the comfort zone, establishing networks, identifying new approaches, moving beyond prototypical research, and getting in contact. This brings us to (5) final considerations, where we return to the notion of social justice. © Springer Science+Business Media B.V. 2009.

Overdenture as a restorative option for hypocalcified-hypoplastic amelogenesis imperfecta: a case report.

AIM: The aim of this report is to describe the restorative treatment of an 18-year-old patient diagnosed with autosomal recessive hypocalcified-hypoplastic amelogenesis imperfecta (AI). BACKGROUND: Esthetic and functional rehabilitations in AI cases are challenging and should consider individual aspects, such as age, socioeconomic status, AI type, and intraoral condition. REPORT: AI was diagnosed in an 18-year-old patient. SUMMARY: Considering the short length of crowns and roots, patient life expectancy, minimal invasiveness, amount of treatment time required, and lower costs, oral rehabilitation with overdentures provided an adequate functional and esthetic rehabilitation of the patient. CLINICAL SIGNIFICANCE: This report demonstrated overdentures to be a viable, relatively inexpensive, and non-invasive treatment choice of a patient with AI with concerns about treatment longevity, invasiveness, cost, esthetics, and long-term maintenance.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation.

The use of fragments of thin veneers as a restorative therapy for anterior teeth disharmony: A case report with 3 years of follow-up

Aim: The present case report described the use of contact lens of thin porcelain veneers as a restorative therapy to solve anterior teeth disharmony. Background: Fragments of thin veneers are minimally invasive restorations with little or no dental preparation and present thickness ranging from 0.2 to 0.5 mm. They are used in case of diastema closure, small changes of teeth, color and restoration of teeth with small fractures. Case report: A 25-year-old man was admitted at a dental clinic complaining about the diastema presence on the upper anterior teeth. Patient was referred to an orthodontic treatment in order to provide better distribution of the diastemas and harmonious proportion of the teeth. Afterwards, contact lens of thin porcelain veneers were fabricated on the six upper anterior teeth. Conclusion: Based on the outcomes of this clinical report, we considered the use of fragments of thin veneers as a successful treatment option after 3 years of follow-up. Clinical significance: The fragments of thin veneers have been established to be an interesting alternative to esthetically restore the anterior teeth with minimal invasiveness. However, since it is a new treatment modality, longitudinal studies are necessary to understand the material's behavior.

Gingival recession associated with noncarious cervical lesions: Combined periodontal-restorative approach and the treatment of long-term esthetic complications

The combined periodontalrestorative approach (that is, a connective tissue graft for root coverage and NCCL restoration with RMGI cement) has demonstrated significant root coverage and a good esthetic outcome. In some cases, though, the color of an RMGI restoration can change over time, compromising esthetics. In this situation, applying composite resin over an RMGI restoration can be a conservative approach to satisfy the patient's esthetic complaint. Long-term observation is necessary to evaluate the stability of the results and establish the success of this approach over time.

Effects of three restorative techniques in the bond strength and nanoleakage at gingival wall of Class II restorations subjected to simulated aging

Objective: To evaluate the effects of simulated aging in bond strength and nanoleakage of class II restorations using three different restorative techniques. Materials and methods: Class II preparations (n = 12) were restored using: FS - composite resin Filtek Supreme Plus (3M/ESPE); RMGIC + FS - resin-modified glass ionomer cement Vitrebond Plus (3M/ESPE) + FS; and FFS + FS - flowable composite resin Filtek Supreme Plus Flowable (3M ESPE) + FS. The teeth were assigned into two groups: Control and Simulated Aging - Thermal/Mechanical cycling (3,000 cycles, 20-80 °C/500,000 cycles, 50 N). From each tooth, two slabs were assessed to microtensile bond strength test (μTBS) (MPa), and two slabs were prepared for nanoleakage assessment, calculated as penetration along the restoration margin considering the penetration length (%) and as the area of silver nitrate particle deposition (μm2). Data were analyzed by two-way analysis of variance (ANOVA) followed by Tukey's post hoc test (p < 0. 05). Results: FS presented the highest μTBS to dentin (22. 39 ± 7. 55 MPa) after simulated aging, while the presence of flowable resin significantly decreased μTBS (14. 53 ± 11. 65 MPa) when compared to no aging condition. Both control and aging groups of RMGIC + FS presented the highest values of silver nitrate penetration (89. 90 ± 16. 31 % and 97. 14 ± 5. 76 %) and deposition area (33. 05 ± 12. 49 and 28. 08 ± 9. 76 μm2). Nanoleakage was not affected by simulated aging. Conclusions: FS presented higher bond strength and lower nanoleakage and was not affected by simulated aging. Use of flowable resin compromised the bond strength after simulated aging. Clinical relevance: The use of an intermediate layer did not improve the dentin bond strength neither reduced nanoleakage at the gingival margins of class II restorations under simulated aging conditions. © 2012 Springer-Verlag.

Growth, distributive justice and social policy

Includes bibliography

Assessment of restorative treatment of patients with amelogenesis imperfecta

Purpose: The purpose of this study was to assess restorative treatment outcomes in the mixed dentition of amelogenesis imperfecta (AI) patients and determine the postrehabilitation oral health status and satisfaction of the patients. Methods: Clinical and radiographic examinations were performed on eight AI patients, who had 74 restorations placed in permanent incisors and molars, to allow evaluation of the integrity of the restorations and periodontal status post-treatment. Subjects completed a survey regarding esthetics, function, and sensitivity. Results: Among the 74 restorations evaluated, seven were lost; of the remaining restorations, 31 were posterior, and 36 were anterior. Ten were rated clinically unacceptable. Teeth with stainless steel crowns had a moderate gingival index (mean=2.3) and plaque index (mean=2.0) scores. Widening of the periodontal ligament and pulp canal obliteration were common radiographic findings. Subject's recall of satisfaction regarding esthetics (P=.002) and sensitivity (brushing-P=.03; eating-P=.01) showed a statically significant difference before and after treatment. Conclusions: During mixed dentition, teeth with amelogenesis imperfecta may be restored with conventional treatment modalities. Direct restorations should be considered interim with multiple repairs anticipated. Post-treatment, gingival inflammation and plaque accumulation were observed. Subjects were satisfied with their appearance and reported a decrease of hypersensitivity. © 2013 Publishing Technology.

Access to information, participation and justice in environmental matters in Latin America and the Caribbean: situation, outlook and examples of good practice [Principle 10 of the Rio Declaration on Environment and Development, 1992]

Principle 10 of the Rio Declaration on Environment and Development, 1992