Aspectos relacionados a procedimentos restauradores em odontopediatria

O objetivo deste texto foi realizar uma revisão crítica de trabalhos realizados após o doutoramento do autor, de parte de uma linha de pesquisa focalizada na dentística em odontopediatria. Desta forma, foram revisados artigos referentes a alguns procedimentos realizados na prática da odontologia restauradora, envolvendo estudos de microinfiltração, onde foi avaliada a influência de técnicas e materiais restauradores sobre este fenômeno. Outros trabalhos revisados relacionaram-se ao uso do microscópio eletrônico de varredura. Neste caso, foram descritos estudos que avaliaram aspectos micromorfológicos das estruturas dentárias (esmalte e dentina) de dentes permanentes, mas principalmente decíduos. Foram observados os efeitos de diferentes tratamentos realizados sobre as estruturas dentárias, como a ação de agentes condicionadores e métodos de desgaste das estruturas dentárias (laser, abrasão a ar, instrumentos cortantes rotatórios e ponta CVD). Também foram apresentados os trabalhos que avaliaram a interface adesiva, após diferentes tratamentos da dentina. Finalmente foram realizados comentários sobre os trabalhos revisados e apresentadas as tendências futuras desta linha de pesquisa.

Methods to evaluate and strategies to improve the biocompatibility of dental materials and operative techniques

Objective. The general aim of this article is to describe the state-of-the-art of biocompatibility testing for dental materials, and present new strategies for improving operative dentistry techniques and the biocompatibility of dental materials as they relate to their interaction with the dentin-pulp complex.Methods. The literature was reviewed focusing on articles related to biocompatibilty testing, the dentin-pulp complex and new strategies and materials for operative dentistry. For this purpose, the PubMed database as well as 118 articles published in English from 1939 to 2014 were searched. Data concerning types of biological tests and standardization of in vitro and in vivo protocols employed to evaluate the cytotoxicity and biocompatibility of dental materials were also searched from the US Food and Drug Administration (FDA), International Standards Organization (ISO) and American National Standards Institute (ANSI).Results. While there is an ongoing search for feasible strategies in the molecular approach to direct the repair or regeneration of structures that form the oral tissues, it is necessary for professionals to master the clinical therapies available at present. In turn, these techniques must be applied based on knowledge of the morphological and physiological characteristics of the tissues involved, as well as the physical, mechanical and biologic properties of the biomaterials recommended for each specific situation. Thus, particularly within modern esthetic restorative dentistry, the use of minimally invasive operative techniques associated with the use of dental materials with excellent properties and scientifically proved by means of clinical and laboratory studies must be a routine for dentists. This professional and responsible attitude will certainly result in greater possibility of achieving clinical success, benefiting patients and dentists themselves.Signcance. This article provides a general and critical view of the relations that permeate the interaction between dental materials and the dentin-pulp complex, and establish real possibilities and strategies that favor biocompatibility of the present and new products used in Dentistry, which will certainly benefit clinicians and their patients. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A method for calculating the compliance of bonded-interfaces under shrinkage: Validation for Class I cavities

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

Effect of surface treatment on the bond strength between yttria partially stabilized zirconia ceramics and resin cement

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Tissue-engineering-based Strategies for Regenerative Endodontics

Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on their potential translation to clinical settings.

Proteins, Pathogens, and Failure at the Composite-Tooth Interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.

Evaluation of tensile tetention of Y-TZP crowns after long-term aging: Effect of the core substrate and crown surface conditioning

This study evaluated the effect of the core substrate type (dentin and composite resin) on the retention of crowns made of yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP), submitted to three inner surface conditionings. For this purpose, 72 freshly extracted molars were embedded in acrylic resin, perpendicular to the long axis, and prepared for full crowns: 36 specimens had crown preparations in dentin; the remaining 36 teeth had the crowns removed, and crown preparations were reconstructed with composite resin plus fiber posts with dimensions identical to the prepared dentin. The preparations were impressed using addition silicone, and 72 Y-TZP copings for the tensile test were produced. Cementation was performed with a dual-cured cement containing phosphate monomers. For cementation, the crown preparation (dentin or resin) was conditioned with the adhesive system, and the ceramic was subjected to one of three surface treatments: isopropyl alcohol, tribochemical silica coating, or thin low-fusing glassy porcelain layer application plus silanization. After 24 hours, all specimens were submitted to thermocycling (6000 cycles) and placed in a special tensile testing device in a universal testing machine to determine failure loads. The failure modes of all samples were analyzed under a stereomicroscope. Two-way analysis of variance showed that the surface treatment and substrate type (alpha=0.05) affected the tensile retention results. The dentin substrate presented the highest tensile retention values, regardless of the surface treatment. When the substrate was resin, the tribochemical silica coating and low-fusing glaze application plus silanization groups showed the higher retention values.

Primate Pulpal Healing after Exposure and TheraCal Application

Aim: The purpose of this in vivo study was to compare the effectiveness of a new light cured resin based dicalcium/tricalcium silicate pulp capping material (TheraCal LC, Bisco), pure Portland cement, resin based calcium hydroxide or glass ionomer in the healing of bacterially contaminated primate pulps. Study design: The experiment required four primates each having 12 teeth prepared with buccal penetrations into the pulpal tissues with an exposure of approximately 1.0 mm. The exposed pulps of the primate teeth were covered with cotton pellets soaked in a bacterial mixture consisting of microorganisms normally found in human pulpal abscesses. After removal of the pellet, hemostasis was obtained and the pulp capping agents applied. The light cured resin based pulp capping material (TheraCal LC) was applied to the pulpal tissue of twelve teeth with a needle tip syringe and light cured for 15 seconds. Pure Portland cement mixed with a 2% Chlorhexidine solution was placed on the exposed pulpal tissues of another twelve teeth. Twelve additional teeth had a base of GIC applied (Triage, Fuji VII GC America) and another twelve had a pulp cap with VLC DYCAL (Dentsply), a light cured calcium hydroxide resin based material. The pulp capping bases were then covered with a RMGI (Fuji II LC GC America). The tissue samples were collected at 4 weeks. The samples were deminerilized, sectioned, stained and histologically graded. Results: There were no statistically significant differences between the groups in regard to pulpal inflammation (H= 0.679, P=1.00). However, both the Portland cement and light cured TheraCal LC groups had significantly more frequent hard tissue bridge formation at 28 days than the GIC and VLC Dycal groups (H= 11.989, P=0.009). The measured thickness of the hard tissue bridges with the pure Portland and light cured TheraCal LC groups were statistically greater than that of the other two groups (H= 15.849, P=0.002). In addition, the occurrence of pulpal necrosis was greater with the GIC group than the others. Four premolars, one each treated according to the protocols were analyzed with a microCT machine. The premolar treated with the light cured TheraCal LC demonstrated a complete hard tissue bridge. The premolar treated with the GIC did not show a complete hard tissue bridge while the premolar treated with VLC Dycal had an incomplete bridge. The pure Portland with Chlorhexidine mixture created extensive hard tissue bridging.Conclusion: TheraCal LC applied to primate pulps created dentin bridges and mild inflammation acceptable for pulp capping.

Efeito do tratamento da superfície dental com os lasers Nd:YAG e Er: Yag na adesão da resina composta à dentina recém clareada

To evaluate the effect of surface treatment with Er:YAG and Nd:YAG laser on resin composite bond strength to recently bleached dentin. Material and Methods: In this study 120 bovine incisors were used and distributed into two groups: Group C: without bleaching treatment; Group B: with bleaching treatment (35% hydrogen peroxide). Each group was divided into three subgroups: Subgroup N: without laser treatment; Subgroup Nd: irradiation with Nd:YAG laser; Subgroup Er: irradiation with Er:YAG laser. Next, the adhesive system (Adper Single Bond 2) was applied and composite buildups were constructed with Z350 composite. The teeth were sectioned to obtain dentin-resin sticks (1x1mm) and analyzed by microtensile bond testing. The data were statistically analyzed by the ANOVA and Tukey tests. Results: The results showed that the bond strength values in the bleached control group (16.17 MPa) presented no significant difference in comparison with the group bleached and irradiated with Er:YAG laser (14.69 MPa). The non bleached control group (26.79 MPa) presented significant difference in bond strength when compared with the non bleached group irradiated with Er:YAG laser (22.82 MPa) and with the group treated by bleaching and irradiation with Nd:YAG laser (28,792 MPa). The group without bleaching treatment and irradiated with Nd:YAG (36.1 MPa) presented a significant increase in bond strength in comparison with the other groups. Conclusion: The use of Nd:YAG laser on bleached specimens was able of completely reversing the immediate effects of bleaching, obtaining bond strength values similar to those of the control group

Efeito da ativação física e química do gel clareador na velocidade de penetração do peróxido de hidrogênio: estudo in vitro

This study evaluated the effect of physical and chemical activation on the speed of penetration of hydrogen peroxide bleaching agents present in different concentrations through the enamel and dentin. One hundred and twenty bovine incisors were used, which were obtained enamel/dentin discs of the buccal surface, with 6 mm in diameter. The samples were divided into six groups: G1 - Hydrogen Peroxide Gel 20%, G2 - Hydrogen Peroxide Gel 20% with light activation, G3 - Hydrogen Peroxide Gel 20% with Manganese Gluconate; G4 - Hydrogen Peroxide Gel 35%; G5 - Hydrogen Peroxide Gel 35% with the light activation and G6 - Hydrogen Peroxide Gel 35% with Manganese Gluconate. The specimens were placed in a transparent support on which there was a substance sensitive to hydrogen peroxide immediately below and in contact with the specimen. After the procedures for applying the gel for each group, one video camera was positioned and operated to monitor the time of penetration of peroxide in each specimen. The recording ended after changing the color of the fluid revealed in all specimens and times were noted for comparison. ANOVA analysis showed that concentration and type of activation of bleaching gel significantly influenced the diffusion time of hydrogen peroxide (P 0.05). 35% hydrogen peroxide showed the lowest diffusion times compared to the groups with 20% hydrogen peroxide gel. The light activation of hydrogen peroxide decrease significantly the diffusion time compared to chemical activation. The highest diffusion time was obtained with 20% hydrogen peroxide chemically activated. The diffusion time of hydrogen peroxide was dependent on activation and concentration of hydrogen peroxide. The higher concentration of hydrogen peroxide diffused through dental tissues more quickly

Propriedades físico-químicas e mecânicas, potencial bioativo e caracterização da interface dentina-cimento de cimentos endodônticos experimentais à base de cimento Portland associados à radiopacificadores micro e nanoparticulados

Pós-graduação em Odontologia - FOAR

Efeito de protocolos de cimentação na carga de fratura para uma cerâmica de dissilicato de lítio

Pós-graduação em Odontologia Restauradora - ICT

Determinação do tempo de vida de restaurações totalmente cerâmicas (y-tzp/porcelana) com incidência da carga em diferentes regiões de contato

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise comparativa da ação antimicrobiana dos cimentos endodônticos Acroseal, Sealapex e AH plus pós presa em biofilme de enterococcus faecalis

Pós-graduação em Ciência Odontólogica - FOA

Influência da superfície dentinária bovina na resistência de união de sistemas adesivos

Pós-graduação em Odontologia Restauradora - ICT