Resumo em Inglês:

As the adaptation of titanium crowns obtained by Rematitan Plus investment, specific for titanium, is not recognized to be suitable, this study evaluated the effect of the concentration of the specific liquid and the temperature of the mold of investments on the internal misfit of crowns cast on commercially pure titanium. Individual dies of epoxy resin were obtained, representing teeth prepared for full-crown restoration with a 6-degree axial surface convergence angle and shoulder (1.0 mm). For the waxing of each crown, a ring-shaped stainless steel matrix (8.0mm internal diameter; 7.5 mm height) was adapted above the individual dies of epoxy resin. The Rematian Plus investment was mixed according to the manufacturer's instructions using two different concentrations of the specific liquid: 100%, 75%. Casting was performed in a Discovery Plasma Ar-arc vacuum-pressure casting machine with molds at temperatures of 430ºC, 515ºC and 600ºC. The crowns were cleaned individually in a solution (1% HF + 13% HNO3) for 10 min using a ultrasonic cleaner, with no internal adaptations, and luted with zinc phosphate cement under a 5 kg static load. The crown and die assemblies were embedded in resin and sectioned longitudinally. The area occupied by cement was observed using stereoscopic lens (10X) and measured by the Leica Qwin image analysis system (mm²). The data for each experimental condition (n=8) were analyzed by Kruskal-Wallis non-parametric test (á=0.05). The results showed that liquid dilution and the increase in mold temperature did not significantly influence the levels of internal fit of the cast titanium crowns. The lowest means (±SD) of internal misfit were obtained for the 430ºC/100%: (7.25 mm² ±1.59) and 600ºC/100% (8.8 mm² ±2.25) groups, which presented statistically similar levels of internal misfit.

Resumo em Inglês:

OBJECTIVE: To evaluate the role of socioeconomic variables and self-perceived oral health in the polarization of caries among adolescents in Santa Bárbara D'Oeste, Brazil. MATERIAL AND METHODS: Cross-sectional study. Sampling was randomized and sample size was defined according to WHO criteria. Two hundred and seventy seven adolescents (15 to 18 year-old) were examined by five trained examiners that assessed DMFT index according to WHO criteria. Self-perceived oral health, access to dental services and socio-demographic variables were self-reported. Student's t tests, chi-square tests, and multivariate logistic regression (with significant caries index (SiC) as the outcome), were performed. RESULTS: Mean DMFT was 5.48 (±4.22) and the proportion of "caries free" subjects was 15.5%. Mean DMFT (9.71±2.85) and mean D (1.67±2.18) of SiC positive subjects were significantly higher than mean DMFT (2.88±2.17) and mean D (0.45±0.87) of SiC negative subjects (p<0.0001). Mean D of white (0.76±1.51) was significantly smaller than mean D of non-white subjects (1.32±2.01). The only variable independently associated with the "SiC positive" outcome was "report of toothache within six months prior to the study" [OR=1.83 (95%CI 1.08 to 3.12)], p<0.001. CONCLUSION: SiC was associated with "report of toothache" but not with socio-demographic variables in the studied population.

Resumo em Inglês:

AIM: The purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (TMD) and vice-versa. MATERIAL AND METHODS: One hundred women (aged 18-26 years) clinically diagnosed with TMD signs and symptoms and cervical spine disorders were randomly selected from a sample of college students. RESULTS: 43% of the volunteers demonstrated the same severity for TMD and cervical spine disorders (CSD). The increase in TMD signs and symptoms was accompanied by increase in CSD severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe CSD group. However, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of TMD severity. CONCLUSION: The increase in cervical symptomatology seems to accompany TMD severity; nonetheless, the inverse was not verified. Such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for TMD.

Resumo em Inglês:

PURPOSE: To evaluate the bond strength between human dentin and composites, using two light-activated single-bottle total-etch adhesive systems with different pHs combined with chemically activated and light-activated-composites. The tested hypothesis was that the dentin bond strength is not influenced by an adhesive system of low pH, combined with chemically activated or light-activated composites. MATERIAL AND METHOD: Flat dentin surfaces of twenty-eight human third molars were allocated in 4 groups (n=7), depending on the adhesive system: (One Step Plus-OS and Prime & Bond NT-PB) and composite (light-activated Filtek Z-100 [Z100] and chemically activated Bisfil 2B [B2B]). Each adhesive system was applied on acid-etched dentin and then one of the composites was added to form a 5 mm-high resin block. The specimens were stored in tap water (37ºC/24 h) and sectioned into two axes, x and y. This was done with a diamond disk under coolant irrigation to obtain beams with a cross-section area of approximately 0.8 mm². Each specimen was then attached to a custom-made device and submitted to the microtensile test (1 mm.min-1). Data were analyzed using two-way ANOVA and Tukey's tests (p<0.05). RESULTS: The anticipated hypothesis was not confirmed (p<0.0001). The bond strengths (MPa) were not statistically different between the two adhesive systems when light-activated composite was used (OS+Z100 = 24.7±7.1ª; PB+Z100 = 23.8±5.7ª). However, with use of the chemically activated composite (B2B), PB (7.8±3.6b MPa) showed significantly lower dentin bond strengths than OS (32.2±7.6ª). CONCLUSION: The low pH of the adhesive system can affect the bond of chemically activated composite to dentin. On the other hand, under the present conditions, the low pH did not seem to affect the bond of light-activated composites to dentin significantly.

Resumo em Inglês:

OBJECTIVE: The aim of this study was to evaluate the effect of C-factor and light-curing protocol on gap formation in composite resin restorations. Material and METHODS: Cylindrical cavities with 5.0 mm diameter and three different depths (A=1.0, B=2.0 and C=3.0 mm) were prepared on the occlusal surface of 30 human molars and restored in a single increment with P 60. The composite resin was light-cured according to two protocols: standard - 850 mW/cm² / 20 s and gradual - 100 up to 1000 mW/cm² / 10 s + 1000 mW/cm² / 10 s. After storage in distilled water (37°C/7 days), the restorations were cut into three slices in a buccolingual direction and the gap widths were analyzed using a 3D-scanning system. The data were submitted to ANOVA and Student-Newman-Keuls test (alpha=0.05). RESULTS: ANOVA detected a significant influence for the C-factor and light-curing protocol as independent factors, and for the double interaction C-factor vs. light-curing protocol. Cavities with higher C-factor presented the highest gap formation. The gradual light-curing protocol led to smaller gap formation at cavity interfaces. CONCLUSIONS: The findings of this study suggest that the C-factor played an essential role in gap formation. The gradual light-curing protocol may allow relaxation of composite resin restoration during polymerization reaction.

Resumo em Inglês:

The centric relation is a mandibular position that determines a balance relation among the temporomandibular joints, the chew muscles and the occlusion. This position makes possible to the dentist to plan and to execute oral rehabilitation respecting the physiological principles of the stomatognathic system. The aim of this study was to investigate the reproducibility of centric relation records obtained using two techniques: Dawson's Bilateral Manipulation and Gysi's Gothic Arch Tracing. Twenty volunteers (14 females and 6 males) with no dental loss, presenting occlusal contacts according to those described in Angle's I classification and without signs and symptoms of temporomandibular disorders were selected. All volunteers were submitted five times with a 1-week interval, always in the same schedule, to the Dawson's Bilateral Manipulation and to the Gysi's Gothic Arch Tracing with aid of an intraoral apparatus. The average standard error of each technique was calculated (Bilateral Manipulation 0.94 and Gothic Arch Tracing 0.27). Shapiro-Wilk test was applied and the results allowed application of Student's t-test (sampling error of 5%). The techniques showed different degrees of variability. The Gysi's Gothic Arch Tracing was found to be more accurate than the Bilateral Manipulation in reproducing the centric relation records.

Resumo em Inglês:

OBJECTIVE: The purpose of this study was to perform a radiographic follow-up evaluation after a 12-month healing period, following crown lengthening surgery. MATERIAL AND METHODS: Twenty-three periodontally healthy subjects (mean age 32.5 years) that required crown lengthening surgery in premolars were recruited. In a total of 30 premolars, full thickness flaps, osseous resection, and flap suturing were performed. The restorative margin was defined in the pre-surgical phase and maintained unaltered during the healing period, serving as a reference point. Standardized bitewing radiographs were taken before and after osseous reduction, and at 2, 3, 6, and 12-month healing periods. RESULTS: Intact lamina dura was observed at both mesial and distal alveolar crests only from the 3rd month. At 12-months, all alveolar crests presented lamina dura. The overall mean distance from the restorative margin to the alveolar crest achieved after osseous resection was 3.28±0.87 mm at mesial and 2.81±0.51 mm at distal sites. No significant radiographic changes in the bone crest were observed during a 12-month healing period. CONCLUSION: The findings of this study suggest that the radiographic proximal bone level observed on bitewing radiographs following crown lengthening surgery can be used as a reference to predict the future level of the healed alveolar crest.

Resumo em Inglês:

OBJECTIVE: The purpose of this study was to evaluate the influence of dentin deproteinization on the nanoleakage phenomenon. MATERIAL AND METHODS: Class V cavities were prepared in 12 human molars with cervical margins located in dentin. The cavities were assigned to 2 groups (n=6) according to dentin treatment: Group I - dentin treated in accordance with the manufacturer's instructions and Group II - dentin treated following the manufacturer's instructions + 10% NaOCl. Each group was sub-divided into three groups, according to the DBS (dentin bonding system) used: Scotchbond Multi Purpose (SBMP), Prime & Bond NT (PB) and Clearfil SE Bond (SE), which were applied according to manufacturer's instructions. The cavities were restored with composite resin, and the specimens were immersed in a tracer agent (AgNO3 50%) for 24 h. The teeth were sectioned buccolingually through the center of the restorations, and nanoleakage pattern was evaluated by scanning electron microscopy (SEM) using the backscattered electron image mode. RESULTS: SEM analysis showed different nanoleakage patterns for each DBS. Irrespective of dentin treatments, all SBMP specimens showed nanoleakage. SE did not show any nanoleakage with both dentin treatments used. PB showed nanoleakage within the hybrid layer only in Group I. CONCLUSIONS: The influence of dentin deproteinization on the nanoleakage phenomenon was dependent on dentin bonding system formulation and bonding strategies.

Resumo em Inglês:

Little information is available on the pathogenesis of fluorosis during the fetal and initial postnatal period. In the present study, female rats received 0 (control), 7 or 100 ppm of sodium fluoride in drinking water, one week before breeding and throughout gestation and nursing periods. The hemimandibles of the offspring were collected at 0, 7 and 14 days of postnatal life (n = 5) and processed for morphological analyses by light and electron microscopy, immunohistochemical analysis for amelogenin and morphometric study of enamel matrix and ameloblasts of incisors. The results showed a decrease in matrix production at the secretory phase at all study periods for the 100 ppm group. In this same group, the secretory ameloblasts showed reduction of enamel matrix secretion, disorganization of mitochondrial crests, large vacuoles at the apical portion of the cytoplasm, retention of intracisternal material and dilatation of some cisterns in the rough endoplasmic reticulum. In the groups of animals aged 7 and 14 days, analysis of variance showed significant reduction (p<0.05) in cytoplasmic volume of 23.80% and 24.75%, respectively, in relation to the control group. The smooth-ended maturation ameloblasts exhibited a large number of vacuoles with electron-dense endocytic matrix, suggesting a delay in the resorption process. Immunohistochemical analysis showed no difference in the intensity and labeling pattern of the enamel matrix in any study group. Interestingly, in offspring at the age of 14 days for the 7 ppm group, there was an increase in the matrix length at the secretory phase. Therefore, part of the excessive dose of sodium fluoride given to the mother in drinking water can reach the offspring through the placenta and mother's milk, causing morphological changes in ameloblasts and suggesting a reduction in secretion and a delay in matrix resorption.

Resumo em Inglês:

The aim of this study was to assess the influence of a fluoridated medium on the mechanical properties of an internal hexagon implant-abutment set, by means of compression, mechanical cycling and metallographic characterization by scanning electronic microscopy. Five years of regular use of oral hygiene with a sodium fluoride solution content of 1500 ppm were simulated, immersing the samples in this medium for 184 hours, with the solutions being changed every 12 hours. Data were analyzed at a 95% confidence level with Fisher's exact test. After the action of fluoride ions, a negative influence occurred in the mechanical cycling test performed in a servohydraulic machine (Material Test System-810) set to a frequency of 15 Hz with 100,000 cycles and programmed to 60% of the maximum resistance of static compression test. The sets tended to fracture by compression on the screw, characterized by mixed ruptures with predominance of fragile fracture, as observed by microscopy. An evidence of corrosion by pitting on sample surfaces was found after the fluoride ions action. It may be concluded that prolonged contact with fluoride ions is harmful to the mechanical properties of commercially pure titanium structures.

Resumo em Inglês:

OBJECTIVE: The purpose of this study was to assess the microhardness of posterior composite resins at different depths varying the post-irradiation time. MATERIALS AND METHODS: For each composite resin [Solitaire 2 (SO) - Heraus Kulzer, P60 (P) - 3M, Prodigy Condesable (PC) - Kerr, Surefil (S) - Dentsply and Alert (A) - Pentron], 6 specimens (3 mm in diameter; 4mm high) were prepared using a black polyurethane cylindrical matrix. The resins were inserted in a bulk increment and light cured for 40 seconds. Microhardness was analyzed at different depths (top, 0.4 mm, 1.0 mm, 2.0mm, 3.0 mm and 4.0 mm) and at two moments (20 minutes and 24 hours after light-curing). Data were analyzed by ANOVA and Tukey's test (p<0.05). RESULTS: Overall, microhardness means decreased significantly with the increase of depth, being lower in the first moment tested. P, S and PC showed the highest microhardness means. CONCLUSION: It may be concluded that the tested composite resins presented a gradual decrease of microhardness as depth increased and this drop was more accentuated for depths beyond 2 mm. For all materials, higher microhardness means were recorded 24 hours after light activation. P60 yielded the best results at the different depths evaluated.

Resumo em Inglês:

OBJECTIVE: This study investigated whether some components of the extracellular matrix and CD68 expression may drive the differences between the central giant cell granuloma (CGCG) of the jaws and giant cell tumor (GCT) of long bones, which present distinct evolution and clinical behavior. MATERIAL AND METHODS: Eight cases of CGCG and 7 cases of GCT were selected and immunohistochemically analyzed to verify the pattern of expression of CD68, tenascin (Tn) and fibronectin (Fn). RESULTS: A large number of the mononuclear cells and multinucleated giant cells CD68+ was observed in both of the studied lesions, indicating histiocyte/ macrophage origin. Seven cases of CGCG of the jaws showed intense staining of Fn, with uniform distribution predominantly. In all 7 cases of GCT of long bones the Fn displayed intense expression, with distribution pattern varying from uniform to reticulate/fibrillar. Six cases of CGCG were intensively stained by Tn, presenting focal expression in half of specimens, and reticulate/ fibrillar pattern of expression in 4 cases. All cases of GCT of the long bones presented intense expression of Tn, uniform distribution, and reticulate/fibrillar pattern of expression in four cases. CONCLUSIONS: The immunoexpression of CD68 in mononuclear cells and multinucleated giant cells and staining patterns of Fn and Tn were similar in both entities. These findings indicate that these proteins could not be used to explain the differences between the CGCG of the jaws and GCT of the long bones.

Resumo em Inglês:

This study aimed to compare the apical sealing of root-end fillings performed with Lysanda (zinc oxide-eugenol paste) with radiopacifiers (iodoform or zinc oxide) and calcium hydroxide. Root-end cavities were prepared and filled with different materials, as follows: Group I - Lysanda paste with iodoform; Group II - Lysanda paste with iodoform and calcium hydroxide; Group III - Lysanda paste with iodoform and zinc oxide; Group IV - Lysanda paste with zinc oxide; Group V - mineral trioxide aggregate (MTA). After filling, the teeth were immersed in 2% methylene blue for analysis of marginal leakage. It was observed that marginal leakage occurred in all groups. Lysanda paste with iodoform showed the lowest leakage, with no statistically significant difference compared to the other groups. All materials can be considered as good options for root-end filling.

Resumo em Inglês:

The bond strength of composite resins (CRs) to dentin is influenced by the interfacial microstructure of the hybrid layer (HL) and the resin tags (TAG). The contemporary self-etching primer adhesive systems overcame the inconvenient of the etch-and-rinse protocol. Studies, however, have demonstrated that HL thickness and TAG length vary according to the wetting time and additional use of acid-etching prior to self-etching primers. This study investigated the localized stress distribution in the HL and the dentin/adhesive interface. Two HL thicknesses (3 or 6 µm), two TAG lengths (13 or 17 µm) and two loading conditions (perpendicular and oblique-25º) were investigated by the finite element (FE) analysis. Five two-dimensional FE models (M) of a dentin specimen restored with CR (38 x 64 µm) were constructed: M1 - no HL and no TAG; M2 - 3 µm of HL and 13 µm of TAG; M3 - 3 µm of HL and 17 µm of TAG; M4 - 6 µm of HL and 13 µm of TAG; and M5 - 6 µm of HL and 17 µm of TAG. Two distributed loadings (L) (20N) were applied on CR surface: L1 - perpendicular, and L2 - oblique (25º). Fixed interfacial conditions were assigned on the border of the dentin specimen. Ansys 10.0 (Ansys®, Houston, PA, USA) software was used to calculate the stress fields. The peak of von Mises (sigmavM) and maximum principal stress (sigmamax) was higher in L2 than in L1. Microstructures (HL and TAG) had no effect on local stresses for L1. Decreasing HL decreased sigmavM and sigmamax in all structures for L2, but the TAG length had influence only on the peributular dentin. The thickness of HL had more influence on the sigmavM and sigmamax than TAG length. The peritubular dentin and its adjacent structures showed the highest sigmavM and sigmamax, mainly in the oblique loading.

Resumo em Inglês:

Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders.