Matriz oclusal para restauração com resina composta de baixa contração: simplificação eficiência

The composite resin is the material of election for direct restorations in posterior teeth currently. The restorative dentistry aims to improve each day the material and facilitate the restorative technique. This paper describes the technique of occlusal matrix made to speed up and preservation the occlusal surface of a first molar tooth affected by caries lesion. A new resin-based composite was used called Silorane, which may be placed in larger increments due the material has low shrinkage and polymerization stress. The use of occlusal matrix associated with a low shrinkage resin composite can simplify the clinical work, and result in a restoration with excellent reproduction of anatomical.

Planejamento multidisciplinar: criação x reprodução

Modern Dentistry offers many alternatives for changing a patient's smile. Using work protocols is essential to obtaining previsibility in the resolution of clinical cases. The aim ofthis paper is to present two clinical protocols for two distinguishable situations, creation and reproduction.

Carga imediata em implantes unitários: revisão da literatura

The possibilities of treatment with dental implants have revolutionized the field of oral rehabilitation in recent years, bringing a number of advantages over conventional prostheses. For years, a surgical protocol was followed that called for maintaining the implant without load for a certain period for osseointegration, but experimental studies have shown that immediate loading of implants also leads to the formation of peri-implant bone tissue along the time, similarly to that observed for conventionally loaded implants. This study aimed to conduct a literature review regarding the use of this alternative rehabilitation with single implants. The immediate loading of single-tooth replacements is presented as an excellent treatment alternative.

Aspectos epidemiológicos da saúde bucal de crianças em um município brasileiro

The Health Sciences, prior to the planning of prevention programs, adopt the tools to analyze the population profile, entitled epidemiological surveys, to obtain data on the need for heathcare and the possibility of treating health events. The aim of this study was to evaluate dental conditions in schoolchildren, aged five to fourteen, enrolled in public schools in Américo Brasiliense, SP Brazil. The dmft and DMFT index, caries experience, and prevalence of fluorosis were analyzed. For this epidemiological study, 1,137 children were selected. Four calibrated dentists performed oral exams according to WHO criteria (1997). The data were collected using descriptive analyses. The results showed that 94% of the five-year-old children were caries free, and the value of dmft was 1.44. DMFT was 1.19 in 12-year-olds. The lowest and the highest fluorosis prevalence could be observed in eight and fourteen-year-olds, respectively. It could be concluded that the city of Américo Brasiliense has developed respectful educational and preventive oral health programs which presented satiosfactory results in the present epidemiological study.

Conhecimento de cárie dental e doença periodontal de professores do ensino fundamental segundo o tipo de instituição (pública ou privada)

Aim: observe the knowledge of dental caries and periodontal disease of primary schoolteachers, according to type of institution (public and private) from Araraquara city. methodology: for that participants were 113 teachers from public schools and 57 from private schools. The instrument of analysis was based on a questionnaire with closed and open questions concerning the etiology, prevention and development of dental caries and periodontal disease. Results: 97,3% of public ́s schoolteachers and 91,2% of private ́s schoolteachers answered that they knows what is dental caries, but they didn ́t answer correctly about the caries etiology as being multifactorial and about methods of prevention. Both of schoolteachers (public and private) had more sucessful when answered about bacterial plaque than periodontal disease and yours manifestation. Conclusion: the dental knowledge of schoolteachers in public and private school was evaluated and limited educational programs should be directed to both public and private schoolteachers, in order to increase the level of dental knowledge of them, so that they can act as educational agents with the children.

Associação de prótese fixa, implantes e estética periodontal para reabilitação de pacientes parcialmente edêntulos

Periodontitis is a chronic inflammatory disease that results in the destruction of teeth and their supporting tissues with subsequent tooth loss. The replacement of missing teeth for implant-supported restorations has proven to be a highly predictable treatment method with good long-term prognosis. However, some consequences of tooth loss prevents dental implant placement in an ideal position, where regenerative procedures are necessary for this type of rehabilitation. Less invasive procedures such as conventional prosthesis emerge as a therapeutic option in cases where there is enough bone structure for implants and patient´s non-acceptance for invasive procedures. Thus, this paper aims to present the resolution of rehabilitation through a noninvasive and multidisciplinary treatment. One female patient referred to the clinic presented maladaptive bilateral mandibular fixed prostheses, endodontic lesions, gingival recession, and root sensitivity. For proper resolution of this case, an association among osseointegrated implants, fixed partial prosthesis, tooth extraction, and aesthetic periodontal procedures with the use of subepithelial connective tissue graft was proposed. After two years, the patient shows excellent aesthetics and chewing. Within the limits of this scenario, this paper discusses the various factors that may affect the choice of a particular treatment modality for the rehabilitation of edentulous single spaces.

Impacto dos problemas de saúde bucal na qualidade de vida de gestantes

Objectives: 1) to evaluate the impact of oral health problems on the quality of life of pregnant women by the simplified Oral Health Impact Profile (OHIP-14) questionnaire as well by the presence of dental caries, periodontal disease and denture use/need; 2) to correlate the sociodemographic variables and the oral health conditions revealed in the clinical examinations with the OHIP-14. Method: In addition to the application of the OHIP-14 questionnaire, clinical examination of the oral conditions (CPI - community periodontal index, DMFT and prosthetic evaluation) was performed on 51 pregnant women, who sought dental treatment between April 2008 and August 2010 at the Preventive Dentistry Clinic. Descriptive analyses were made for sample characterization, bivariate analysis (chi-square or Fisher’s exact tests) and multiple logistic regressions at a 5% significance level to assess the correlation between the impact of oral health on the quality of life of pregnant women and the socio-demographic and clinical variables. Results: The OHIP-14 data showed a lesser impact of oral health on the women’s quality of life. The mean DMFT was 12.8; 70.6% of the pregnant women presented dental calculus and 58.8% needed prostheses. The association between OHIP-14 data and last dental visit and DMFT remained in the final regression model (p<0.05). Conclusion: Caries experience of the pregnant women was considered high. Most of them needed prostheses and presented dental calculus. The OHIP-14 presented a low impact on this population and was significantly influenced by the last dental visit and the DMFT index.

Reparo de uma restauração classe IV com o uso de resina composta nanoparticulada: quatro anos de acompanhamento

O aprimoramento da odontologia estética restauradora está ligado ao desenvolvimento de materiais e técnicas inovadoras, os quais podem oferecer diversos benefícios, incluindo a integração cromática, policromatismo, forma anatômica, função, adequado contato proximal e aumento da integridade marginal. Em função desses aspectos, as restaurações de resina composta, aplicadas de forma direta, tendem a ganhar maior longevidade. Assim, o objetivo do presente relato de caso é fornecer ao leitor a visão dos desafios restauradores envolvidos no reparo de uma fratura classe IV de um dente incisivo superior, utilizando-se um novo sistema de resina composta híbrida nanoparticulada (FiltekTM Supreme - 3M ESPE). Resultados: com base no referido material e técnica, otimizamos a obtenção de resultados satisfatórios alcançados por meio da utilização adequada do sistema adesivo e resina composta, mantidos com sucesso após o acompanhamento de 4 anos. Conclusão: pode-se concluir que, interagindo técnica adequada de aplicação, princípios adesivos básicos e materiais de qualidade, o clínico pode garantir o sucesso na restauração da forma, função e estética de dentes anteriores.

Diagnóstico radiográfico diferencial das reabsorções radiculares internas e externas entre especialistas em endodontia e clínicos gerais

Objectives: The objective of this study was to evaluate the ability of endodontists and general practioners to perform the differential radiographic diagnosis between internal and external root resorptions, using digitized periapical radiographs. Methods: Thirty periapical radiographic images of external and internal resorption were selected. The evaluators were comprised of 15 endodontists and 29 general practitioners who answered a questionnaire with the following question: “What type of resorption in the following radiographics do you diagnose?” (1) Inflammatory external root resorption. (2) Internal root resorption. Statistical analysis was performed based on the Mann-Whitney test, with significance level of 5%. Results: There was no statistically significant difference in the percentage of correct answers from specialists in endodontics and general practitioners. Conclusions: Both groups demonstrated satisfactory skill in the radiographic interpretation of internal and external resorption and there was a higher percentage of correct diagnosis of internal resorption than the external.

Push-out bond strength of calcium hydroxide and mineral trioxide aggregate based sealers

The adhesiveness of six root canal sealers: Acroseal, Endo CPM, Epiphany, White MTA, Sealapex and Sealer 26 to dentin, was evaluated in a push-out test design. Methods: Twenty eight roots of freshly extracted teeth were gauged with a size 5 Largo drill. With a cutting machine slices of 2 mm were prepared, rinsed with 5.25% NaOCl and a final rinse with 17% EDTA, dried and filled with one of the sealers. After setting their bond strength was measured in a mechanical testing machine. The data were statistically analyzed by using a One Way ANOVA and post hoc Tukey test. Results: The mean and standard deviation from values of bond strength was: Sealapex 2.2±0.4; Endo CPM 3.8±1.3; White MTA 6.0±1.4; Epiphany 10.9±2.6; Sealer 26 12.3±2.3; and Acroseal 12.2±1.4. Acroseal, Sealer 26 and Epiphany presented a significantly (P<0.01) greater bond strength compared with the other sealers. Also White MTA showed higher adhesiveness compared with Endo CPM and Sealapex (P<0.01). Conclusion: The bond strength between endodontic sealers and root dentin was maximal when Acroseal, Sealer 26 and Epiphany were used; Sealapex e Endo CPM, in turn, presented the lowest bond strength mean values.

Análise dos troncos radiculares, abertura da raízes e projeções cervicais de esmalte de furcas de molares superiores e inferiores: Estudo in vitro

Periodontal treatment of teeth with furcation lesions often have unpredictable results due to several factors that may hinder therapy or influence the progress of periodontal disease. Of these, the length of the root trunk may contribute to the early injury of the furcations or even cause complications for the application of the treatment; the opening of the roots can guide the type of treatment to be instituted and cervical enamel projections may hinder the instrumentation of the region or even act as a retention plate niche. Thus, the purpose of this study was measured using a digital caliper, root logs database 400 molar both the 1st and the 2nd and both upper and lower as well as analyze using appropriate index type projection cervical enamel and through appropriate classification the opening of the roots in order to guide the diagnosis and treatment plan. We conclude that there is variation in measures of root trunk between the faces of the teeth examined and that greater cervical enamel projection (ECP) correlates with a decrease in the length of the root trunk in the sample evaluated as the first molars have higher occurrence of roots with a degree of opening larger than the second molars.

O Papel do cirurgião-dentista nas desordens alimentares: uma revisão de literatura

As desordens alimentares são um grupo de desordens psicopatológicas, nas quais o paciente relaciona os alimentos ingeridos com seu próprio corpo e, podem ameaçar a vida, como a anorexia e bulimia nervosa. Durante a progressão das desordens alimentares, pode ocorrer uma série de manifestações orais, as quais exercem um papel fundamental no diagnóstico, caracterização e prognóstico dessas desordens. O cirurgião dentista é, na maioria das vezes, o primeiro profissional da saúde a observar os sintomas clínicos de uma desordem alimentar. O objetivo deste trabalho foi realizar uma revisão de literatura sobre a etiologia, características, manifestações orais, e tratamento das lesões orais decorrentes das desordens alimentares. A pesquisa foi realizada nas bases de dados PubMed, SciELO, Bireme, durante o período de 1987 a 2013. Verifica-se assim que os primeiros sinais desenvolvidos em pacientes com desordens alimentares aparecem na cavidade oral, cabendo ao cirurgião dentista identificar esses sinais e relacioná-los às desordens.

Recobrimento radicular para o tratamento de hipersensibilidade dentinária cervical persistente

Gingival recession has a high prevalence in the population. This alteration may promote several complications such as cervical dentinal hypersensitivity (HSDC), carious and non-carious cervical lesions, and cosmetic changes due to the increase of the clinical crown length. To treat HSDC there are several therapeutic possibilities that should aim to eliminate pain after external stimulus. Treatment of this alteration can be performed by a conventional or invasive procedure, depending on the clinical condition and patients' desires. In situations where aesthetics is not the main complaint and HSDC persists even after conservative procedures, it is possible to indicate a procedure to achieve root coverage in Miller's Class I and II recessions. The aim of this paper is to report a case where the HSDC was not eliminated by conventional methods, which was resolved only after performing a minimally invasive surgery that promoted total root coverage.