Resumo em Inglês:

Regional odontodysplasia (RO) is a rare developmental anomaly involving both mesodermal and ectodermal dental components in a group of contiguous teeth. It affects the primary and permanent dentitions in the maxilla and mandible or both jaws. Generally it is localized in only one arch. The etiology of this dental anomaly is uncertain. Clinically, affected teeth have an abnormal morphology, are soft on probing and typically discolored, yellow or yellowish-brown. Radiographically, the affected teeth show a "ghostlike" appearance. This paper reports the case of a 5-year-old girl presenting this rare anomaly on the left side of the maxillary arch, which crossed the midline. The primary maxillary left teeth (except for the canine) and the primary maxillary right central incisor were missing due to previous extractions. The permanent teeth had a "ghostlike" appearance radiographically. The treatment performed was rehabilitation with temporary partial acrylic denture and periodic controls. In the future, the extraction of affected permanent teeth and rehabilitation with dental implants will be evaluated. The presentation of this case adds valuable information to pediatric dentists to review special clinical and radiographic features of RO, which will facilitate the diagnosis and treatment of patients with this condition.

Resumo em Inglês:

The aim of this study was to evaluate the influence of different light-curing units on the tensile bond strength and microhardness of a composite resin (Filtek Z250 - 3M/ESPE). Conventional halogen (Curing Light 2500 - 3M/ESPE; CL) and two blue light emitting diode curing units (Ultraled - Dabi/Atlante; UL; Ultrablue IS - DMC; UB3 and UB6) were selected for this study. Different light intensities (670, 130, 300, and 600 mW/cm², respectively) and different curing times (20s, 40s and 60s) were evaluated. Knoop microhardness test was performed in the area corresponding to the fractured region of the specimen. A total of 12 groups (n=10) were established and the specimens were prepared using a stainless steel mold composed by two similar parts that contained a cone-shaped hole with two diameters (8.0 mm and 5.0 mm) and thickness of 1.0 mm. Next, the specimens were loaded in tensile strength until fracture in a universal testing machine at a crosshead speed of 0.5 mm/min and a 50 kg load cell. For the microhardness test, the same matrix was used to fabricate the specimens (12 groups; n=5). Microhardness was determined on the surfaces that were not exposed to the light source, using a Shimadzu HMV-2 Microhardness Tester at a static load of 50 g for 30 seconds. Data were analyzed statistically by two-way ANOVA and Tukey's test (p<0.05). Regarding the individual performance of the light-curing units, there was similarity in tensile strength with 20-s and 40-s exposure times and higher tensile strength when a 60-s light-activation time was used. Regarding microhardness, the halogen lamp had higher results when compared to the LED units. For all light-curing units, the variation of light-exposure time did not affect composite microhardness. However, lower irradiances needed longer light-activation times to produce similar effect as that obtained with high-irradiance light-curing sources.

Resumo em Inglês:

The aim of this study was to evaluate the early and 12-month bond strength of two adhesive systems (Single Bond-SB and One Step-OS) applied to demineralized dentin (WH) and demineralized/NaOCl-treated dentin (H). Twenty flat dentin surfaces were exposed, etched, rinsed and slightly dried. For the H groups, a solution of 10% NaOCl was applied for 60 s, rinsed (15 s) and slightly dried. The adhesives were applied according to the manufacturer's instructions and composite resin crowns were incrementally constructed. After 24 h (water-37ºC), the specimens was sectioned in order to obtain resin-dentin sticks (0.8 mm²). The specimens were tested in microtensile (0.5 mm/min) immediately (IM) or after 12 months of water storage (12M). The data (MPa) were subjected to ANOVA and Tukey's test (a=0.05). Only the main factors adhesive and time were significant (p=0.004 and p=0.003, respectively). SB (42.3±9.1) showed higher bond strengths than OS (33.6±11.6). The mean bond strength for IM-group (42.5±8.7) was statistically superior to 12M (33.3±11.8). The use of 10% NaOCl, after acid etching, did not improve the immediate and the long-term resin-dentin bond strength.

Resumo em Inglês:

Objectives: a) to evaluate the interexaminer reliability in caries detection considering different diagnostic thresholds and b) to indicate, by using Kappa statistics, the best way of measuring interexaminer agreement during the calibration process in dental caries surveys. Methods: Eleven dentists participated in the initial training, which was divided into theoretical discussions and practical activities, and calibration exercises, performed at baseline, 3 and 6 months after the initial training. For the examinations of 6-7-year-old schoolchildren, the World Health Organization (WHO) recommendations were followed and different diagnostic thresholds were used: WHO (decayed/missing/filled teeth - DMFT index) and WHO + IL (initial lesion) diagnostic thresholds. The interexaminer reliability was calculated by Kappa statistics, according to WHO and WHO+IL thresholds considering: a) the entire dentition; b) upper/lower jaws; c) sextants; d) each tooth individually. Results: Interexaminer reliability was high for both diagnostic thresholds; nevertheless, it decreased in all calibration sections when considering teeth individually. Conclusion: The interexaminer reliability was possible during the period of 6 months, under both caries diagnosis thresholds. However, great disagreement was observed for posterior teeth, especially using the WHO+IL criteria. Analysis considering dental elements individually was the best way of detecting interexaminer disagreement during the calibration sections.

Resumo em Inglês:

This study evaluated the influence of curing tip distance, shade and filler particle size on Vickers microhardness (VHN) of composite resins. Two composites were tested: Filtek Z250 microhybrid (3M ESPE; shades A1 and A3.5) and Filtek Supreme nanofilled (3M ESPE; shades A1B and A3.5B). For each resin, 42 specimens (5 mm in diameter and 2 mm height) were prepared being 21 for each shade. The specimens were exposed using a 20-second exposure to a quartz-tungsten-halogen light source with an irradiance of approximately 560 mW/cm², at the following distances: 0 mm (surface contact), 6 mm and 12 mm from composite surface. Effectiveness of cure of different resins, shades and curing distances was determined by measuring the top and bottom hardness (VHN) of specimens using a digital microhardness tester (load: 50 g; dwell time: 45 seconds) 24 hours following curing. The hardness ratio was calculated by dividing VHN of the bottom surface by VHN of top surface. Three-way ANOVA and Tukey's post-hoc test (p<0.05) revealed statistically significant differences for all analyzed factors. As for top hardness, as microhardness ratio (bottom/top), the factors shade, distance and composite filler particle size exerted influence on resin curing. Lighter shade composites (A1 and A1B) showed higher hardness values. At 6 and 12 mm curing tip distances, hardness was lower when compared to 0 mm. The microhybrid composite resin presented higheer hardness, being its microhardness ratio satisfactory only at 0 mm for both shades and at 6 mm for the lighter shade. The nanofilled composite resin did not present satisfactory microhardness at the bottom while the microhybrid composite resin had higher hardness than the nanofilled. Composite's curing tip distance and shade can influence hardness.

Resumo em Inglês:

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

Resumo em Inglês:

The purpose of this study was to evaluate the individual contraction force during polymerization of a composite resin (Z-250), a flowable composite (Filtek Flow, FF) and a resin-modified glass ionomer cement (Vitrebond, VB), and the transmission of Z-250 composite resin polymerization contraction force through different thicknesses of FF and VB. The experiment setup consisted of two identical parallel steel plates connected to a universal testing machine. One was fixed to a transversal base and the other to the equipment's cross head. The evaluated materials were inserted into a 1-mm space between the steel plates or between the inferior steel plate and a previously polymerized layer of an intermediate material (either FF or VB) adhered to the upper steel plate. The composite resin was light-cured with a halogen lamp with light intensity of 500 mW/cm² for 60 s. A force/time graph was obtained for each sample for up to 120 s. Seven groups of 10 specimens each were evaluated: G1: Z-250; G2: FF; G3: VB; G4: Z-250 through a 0.5-mm layer of FF; G5: Z-250 through a 1-mm layer of FF; G6: Z-250 through a 0.5-mm of VB; G7: Z-250 through a 1-mm layer of VB. They were averaged and compared using one-way ANOVA and Tukey test at a = 0.05. The obtained contraction forces were: G1: 6.3N + 0.2N; G2: 9.8 + 0.2N; G3: 1.8 + 0.2N; G4: 6.8N + 0.2N; G5: 6.9N + 0.3N; G6: 4.0N + 0.4N and G7: 2.8N + 0.4N. The use of VB as an intermediate layer promoted a significant decrease in polymerization contraction force values of the restorative system, regardless of material thickness. The use of FF as an intermediate layer promoted an increase in polymerization contraction force values with both material thicknesses.

Resumo em Inglês:

The purpose of this study was to investigate the effect of different surface treatments on shear bond strength of saliva-contaminated resin-resin interfaces. Flat resin surfaces were fabricated. In the control group, no contamination or surface treatment was performed. The resin surfaces of the experimental groups were contaminated with saliva and air-dried, and then submitted to: (G1) rinsing with water and drying; (G2) application of an adhesive system; (G3) rinsing and drying, abrasion with finishing disks, etching and application of adhesive system; (G4) rinsing and drying, etching, application of silane and adhesive system. Resin cylinders were placed over the treated surfaces. The specimens were stored in water or ethanol. Shear bond strength tests were performed and the mode of failure was evaluated. Data were submitted to two-way ANOVA and Dunnett T3 test. Contamination of resin-resin interfaces with saliva significantly reduced shear strength, especially after prolonged storage (p<0.05). Similar values to the original bond strength were obtained after abrasion and application of adhesive (G3) or etching and application of silane and adhesive (G4). If contamination occurs, a surface treatment is required to guarantee an adequate interaction between the resin increments.

Resumo em Inglês:

This study evaluated the effect of water-bath and microwave post-polymerization treatments on the flexural strength and Vickers hardness of four autopolymerizing reline resins (Duraliner II-D, Kooliner-K, Tokuso Rebase Fast-TR and Ufi Gel Hard C-UGH) and one heat-polymerized acrylic resin (Lucitone 550-L), processed using two polymerization cycles (short cycle - 90 minutes at 73ºC and 100ºC for 30 minutes; and long cycle - 9 hours at 71ºC). For each material, thirty specimens (64 x 10 x 3.3 mm) were made and divided into 3 groups (n=10). Specimens were tested after: processing (control group); water-bath at 55ºC for 10 minutes (reline materials) or 60 minutes (L); and microwave irradiation. Flexural strength tests were performed at a crosshead speed of 5 mm/min using a three-point bending device with a span of 50 mm. The flexural strengths values were calculated in MPa. One fragment of each specimen was submitted to Vickers hardness test. Data were analyzed by 2-way ANOVA followed by Tukey's HSD test (alpha=0.05). L microwaved specimens (short cycle) exhibited significantly higher flexural strength means than its respective control group (p<0.05). Water-bath promoted a significant increase (p<0.05) in flexural strength of K and L (long cycle). The hardness of the tested materials was not influenced by the post-polymerization treatments. Post-polymerization treatments could be used to improve the flexural strength of some materials tested.

Resumo em Inglês:

Given that tobacco smoking habit is a risk factor for periodontal diseases, the aim of this study was to compare clinical periodontal aspects between smokers and non-smokers. The clinical status were assessed in 55 patients, 29 smokers and 26 non-smokers, aged 30 to 50 years, with mean age of 40. The clinical parameters used were: probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), gingival recession (GR) and gingival bleeding index (GBI) for arches (upper and lower ) and teeth (anterior and posterior). Tooth loss was also evaluated in both groups. Multiple regression analysis showed: tendency of greater probing depth and clinical attachment level means for smokers; greater amount of plaque in smokers in all regions; greater gingival index means for non-smokers with clinical significance (p<0.05) in all regions. Although, without statistical significance, the analysis showed greater gingival bleeding index means almost always for non-smokers; similar gingival recession means in both groups and tendency of upper tooth loss in smokers and lower tooth loss in non-smokers. The findings of this study showed that clinical periodontal parameters may be different in smokers when compared to non-smokers and that masking of some periodontal signs can be a result of nicotine's vasoconstrictor effect.

Resumo em Inglês:

This study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (LBW) and a matched control group of term children with normal birth weight (NBW). The study sample consisted of 61 children born preterm and with LBW examined at 18-34 months of age. The control group was formed by 61 infants born full term and with NBW examined at 31-35 months of age. All children were born at the Center of Integrated Attention of Women's Health (CAISM-UNICAMP). FDI criteria were followed for dental examination. Medical data was collected retrospectively from hospital records. Among preterms, 57.4% had some type of developmental defects of enamel (DDE), 52.5 % had opacities and 21.3 % presented hypoplasia. Among full-term children, 24.6% presented DDE, 24.6% had opacities and 3.3% had hypoplasia. LBW preterm infants presented a higher prevalence of hypoplasia than NBW controls. The deciduous teeth most affected by hypoplasia were maxillary incisors. There was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.

Resumo em Inglês:

The purposes of this study were to investigate radiographically the dental and maxillomandibular in patients with neuropsychomotor disorders and determine the role of panoramic radiographs for quantitative and qualitative analyses of dental alterations. A total of 322 panoramic radiographs from 190 males and 132 females aged 4 to 57 years were obtained from the files of the Center for Care to Patients with Special Needs (CAPE; Dental School, University of São Paulo) and subdivided into syndromes, special needs, neurological, neuromuscular or cerebral disorders, and sequels of diseases. 32% of dental alterations were in tooth position, with 69% of this group associated with tooth rotation. The mandible accounted for 54.62% of alterations. The male gender (55.85%) and the permanent dentition (78.7%) were most affected. Panoramic radiographs were proved to be well suited for quantitative evaluation of dental anomalies of epidemiological nature. Panoramic radiographs are important diagnostic resources when applied to patients with special needs because of the difficulty to place intraoral films and held them correctly positioned during the radiographic technique.

Resumo em Inglês:

The purpose of this study was to validate the elastomeric impression after temporary tooth separation as a method of cavitation detection in proximal caries lesions in primary molars with outer half dentin radiolucency. Fifty-one children (4-10 years old), presenting radiolucency in the outer half of the dentin at the proximal surfaces of primary molars and proximal anatomic contact with the adjacent tooth (without restoration/cavitated caries lesion) were enrolled in the study. Temporary tooth separation was performed with an orthodontic rubber ring placed around the contact point during 2-3 days. Thereafter, impression of the proximal surfaces was made. The elastomeric impressions were classified as "non-cavitated" or "cavitated" surfaces. Visual inspection after tooth separation was considered as the gold standard. Examiner reliability of visual inspection after tooth separation was determined (kappa 0.92). Impression examination was repeated every 5 participants to evaluate the reproducibility of the method. The frequency of cavitated lesions was 65%, and 67% of those were inactive. Sensitivity, specificity, positive and negative predictive values were 0.88% (95%CI 0.73-0.95), 0.89% (95%CI 0.67-0.97), 0.94% (95%CI 0.79-0.98) and 0.80% (95%CI 0.58-0.92), respectively. Impression examination showed total agreement regarding cavitation. The evaluation of elastomeric impression after tooth separation is a useful clinical resource in cavitation detection for clinicians and researchers when visual inspection is doubtful.

Resumo em Inglês:

Tooth avulsion is a very common event in children and emergency care procedures are crucial for case prognosis. As anyone at the moment of accident can provide first-aid measures, knowledge of school professionals dealing with children is of paramount importance. An informative campaign about dental trauma was performed in urban schools in the city of Adamantina, São Paulo state, Brazil, in an attempt to educate school professionals about emergency procedures in cases of tooth avulsion. A questionnaire arguing on personal information, tooth avulsion knowledge and personal impressions of the campaign was handed out for evaluation of the informative campaign. Eighty school professionals participated in the survey. Most participants were females (93.75%) aged 41-60 years old (53.75%) with a college degree (77.5%). Time at work ranged from 1-5 years (22.5%). The efficacy of the campaign was considered positive, as 100% of the interviewees replied to the importance of emergency procedures in case of tooth avulsion. In addition, 81.25% of the respondents answered that they would store the avulsed tooth in some storage medium, of which milk was the most frequently mentioned (84.61%). The participants considered the campaign as satisfactory and a region-wide campaign will be accomplished at other schools.

Resumo em Inglês:

Endodontic infections are mixed aerobic-anaerobic infections and several microbial groups associated to these pathologies are also involved in orofacial infections. The goal of this study was to evaluate the susceptibility of microorganisms isolated from endodontic infections to beta-lactams and metronidazole and verify the production of beta-lactamases. Clinical specimens were collected from 58 endodontic infections of 52 patients. The microorganisms were isolated in selective and non-selective culture media, under anaerobiosis and aerobiosis, and identified using biochemical methods. In the susceptibility tests, it was used an agar dilution method, and Wilkins-Chalgren agar enriched with blood, hemin and menadione for the anaerobes, while Mueller-Hinton agar was employed for the facultative anaerobes. The production of beta-lactamases was evaluated through the biological and chromogenic cephalosporin methods. All tested isolates were sensitive to imipenem and 99.3% to amoxicillin/clavulanate association, while 16.1% showed resistance to amoxicillin and penicillin G, and 4.89% to cefoxitin. Resistance to metronidazole was just found in facultative anaerobes. Production of beta-lactamases was detected in 18.2% of the isolates and presented a correlation with resistance to beta-lactams.