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Journal of Applied Oral Science, Volume: 17, Número: 6, Publicado: 2009
  • Guest Editorial: referred pain

    Murray, Greg M.
  • Cytotoxicity and biocompatibility of direct and indirect pulp capping materials Review

    Modena, Karin Cristina da Silva; Casas-Apayco, Leslie Caroll; Atta, Maria Teresa; Costa, Carlos Alberto de Souza; Hebling, Josimeri; Sipert, Carla Renata; Navarro, Maria Fidela de Lima; Santos, Carlos Ferreira

    Resumo em Inglês:

    There are several studies about the cytotoxic effects of dental materials in contact with the pulp tissue, such as calcium hydroxide (CH), adhesive systems, resin composite and glass ionomer cements. The aim of this review article was to summarize and discuss the cytotoxicity and biocompatibility of materials used for protection of the dentin-pulp complex, some components of resin composites and adhesive systems when placed in direct or indirect contact with the pulp tissue. A large number of dental materials present cytotoxic effects when applied close or directly to the pulp, and the only material that seems to stimulate early pulp repair and dentin hard tissue barrier formation is CH.
  • Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals Original Articles

    Valera, Marcia Carneiro; Silva, Katy Costa Godinho da; Maekawa, Lilian Eiko; Carvalho, Cláudio Antonio Talge; Koga-Ito, Cristiane Yumi; Camargo, Carlos Henrique Ribeiro; Lima, Raphael Silva e

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. MATERIAL AND METHODS: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. RESULTS AND CONCLUSIONS: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.
  • Protective effect of green tea on dentin erosion and abrasion Original Articles

    Kato, Melissa Thiemi; Magalhães, Ana Carolina; Rios, Daniela; Hannas, Angélica Reis; Attin, Thomas; Buzalaf, Marília Afonso Rabelo

    Resumo em Inglês:

    OBJECTIVE: This in situ study evaluated the protective effect of green tea on dentin erosion (ERO) and erosion-abrasion (ABR). MATERIAL AND METHODS: Ten volunteers wore intraoral palatal appliances with bovine dentin specimens subjected to ERO or ERO + toothbrushing abrasion performed immediately (ERO+I-ABR) or 30 min after erosion (ERO+30-min-ABR). During 2 experimental 5-day crossover phases, the volunteers rinsed with green tea or water (control, 1 min) between each erosive (5 min, cola drink) and abrasive challenge (30 s, toothbrushing), 4x/day. Dentin wear was measured by profilometry. RESULTS: The green tea reduced the dentin wear significantly for all conditions compared to control. ERO+I-ABR led to significantly higher wear than ERO, but it was not significantly different from ERO+30-min-ABR. ERO+30-min-ABR provoked significant higher wear than ERO, only for the placebo treatment. CONCLUSIONS: From the results of the present study, it may be concluded that green tea reduces the dentin wear under erosive/abrasive conditions.
  • A survey of cross-infection control procedures: knowledge and attitudes of Turkish dentists Original Articles

    Yüzbasioglu, Emir; Saraç, Duygu; Canbaz, Sevgi; Saraç, Y. Sinasi; Cengiz, Seda

    Resumo em Inglês:

    OBJECTIVES: The objective of this study was to investigate the knowledge, attitudes and behavior of Turkish dentists in Samsun City regarding cross-infection control. MATERIAL AND METHODS: A questionnaire was designed to obtain information about procedures used for the prevention of cross-infection in dental practices and determine the attitudes and perceptions of respondent dental practitioners to their procedures. The study population included all dentists in the city of Samsun, Turkey, in April 2005 (n=184). The questionnaire collected data on sociodemographic characteristics, knowledge and practice of infection control procedures, sterilization, wearing of gloves, mask, use of rubber dam, method of storing instruments and disposal methods of contaminated material, etc. Questionnaire data was entered into a computer and analyzed by SPSS statistical software. RESULTS: From the 184 dentists to whom the questionnaires were submitted, 135 participated in the study (overall response rate of 73.36%). As much as 74.10% dentists expressed concern about the risk of cross-infection from patients to themselves and their dental assistants. Forty-three percent of the participants were able to define "cross-infection" correctly. The greatest majority of the respondents (95.60%) stated that all patients have to be considered as infectious and universal precautions must apply to all of them. The overall responses to the questionnaire showed that the dentists had moderate knowledge of infection control procedures. CONCLUSIONS: Improved compliance with recommended infection control procedures is required for all dentists evaluated in the present survey. Continuing education programs and short-time courses about cross-infection and infection control procedures are suitable to improve the knowledge of dentists.
  • Glass transition and degree of conversion of a light-cured orthodontic composite Original Articles

    Sostena, Michela M. D. S.; Nogueira, Renata A.; Grandini, Carlos R.; Moraes, João Carlos Silos

    Resumo em Inglês:

    OBJECTIVE: This study evaluated the glass transition temperature (Tg) and degree of conversion (DC) of a light-cured (Fill Magic) versus a chemically cured (Concise) orthodontic composite. MATERIAL AND METHODS: Anelastic relaxation spectroscopy was used for the first time to determine the Tg of a dental composite, while the DC was evaluated by infrared spectroscopy. The light-cured composite specimens were irradiated with a commercial LED light-curing unit using different exposure times (40, 90 and 120 s). RESULTS: Fill Magic presented lower Tg than Concise (35-84ºC versus 135ºC), but reached a higher DC. CONCLUSIONS: The results of this study suggest that Fill Magic has lower Tg than Concise due to its higher organic phase content, and that when this light-cured composite is used to bond orthodontic brackets, a minimum energy density of 7.8 J/cm² is necessary to reach adequate conversion level and obtain satisfactory adhesion.
  • Fracture strength of flared bovine roots restored with different intraradicular posts Original Articles

    Clavijo, Victor Grover Rene; Reis, José Maurício dos Santos Nunes; Kabbach, William; Silva, André Luis Faria e; Oliveira Junior, Osmir Batista de; Andrade, Marcelo Ferrarezi de

    Resumo em Inglês:

    OBJECTIVE: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. MATERIAL AND METHODS: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI- cast metal post-and-core; GII- fiber posts plus accessory fiber posts; GIII- direct anatomic post; GIV- indirect anatomic post and GV- control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135º to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (α=0.05). RESULTS: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100% of unfavorable failures. GII presented 20% of unfavorable failures. GIII, GIV and GV presented only favorable failures. CONCLUSIONS: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core.
  • Effect of eugenol-based endodontic sealer on the adhesion of intraradicular posts cemented after different periods Original Articles

    Dias, Larissa Lustosa Lima; Giovani, Alessandro Rogério; Silva Sousa, Yara Teresinha Corrêa; Vansan, Luiz Pascoal; Alfredo, Edson; Sousa-Neto, Manoel Damião; Paulino, Silvana Maria

    Resumo em Inglês:

    OBJECTIVE: This study evaluated in vitro the influence of an eugenol-based sealer (EndoFill) on the retention of stainless steel prefabricated posts cemented with zinc phosphate and resin-based (Panavia F) cements after different periods of root canal obturation, using the pull-out test. MATERIAL AND METHODS: Sixty upper canines were decoronated and the roots were embedded in resin blocks. The specimens were distributed into 3 groups, according to the period elapsed between canal obturation and post cementation: Group I - immediately; Group II - 72 h and Group III - 4 months. The groups were subdivided according to the type of cement used for post cementation: A - zinc phosphate and B - Panavia F. Following the experimental periods, specimens were subjected to pullout test in an Instron machine with application of tensile force at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal were recorded (kN) and means were subjected to statistical analysis by 2-way ANOVA and Tukey-Kramer test (α=0.001) RESULTS: There were statistically significant differences (p<0.01) between the posts cemented with zinc phosphate cement (0.2112 kN) and Panavia F (0.0501 kN). However, no statistically significant differences (p>0.05) were found between the three post cementation periods, regardless of the cement. CONCLUSIONS: It was concluded that the eugenol-based sealer influenced the tensile strength of the posts cemented with the resin cement, but had no influence on the time waited between root canal obturation and post space preparation/post cementation.
  • Influence of microwave sterilization on the cutting capacity of carbide burs Original Articles

    Fais, Laiza Maria Grassi; Pinelli, Lígia Antunes Pereira; Adabo, Gelson Luis; Silva, Regina Helena Barbosa Tavares da; Marcelo, Caroline Canhizares; Guaglianoni, Dalton Geraldo

    Resumo em Inglês:

    OBJECTIVE: This study compared the cutting capacity of carbide burs sterilized with microwaves and traditional sterilization methods. MATERIAL AND METHODS: Sixty burs were divided into 5 groups according to the sterilization methods: dry heat (G1), autoclave (G2), microwave irradiation (G3), glutaraldehyde (G4) or control - no sterilization (G5). The burs were used to cut glass plates in a cutting machine set for twelve 2.5-min periods and, after each period, they were sterilized (except G5) following the protocol established for each group. The cutting capacity of the burs was determined by a weight-loss method. Data were analyzed statistically by Kruskal-Wallis and Dunn's test. RESULTS: The means of the cutting amount performed by each group after the 12 periods were G1 = 0.2167 ± 0.0627 g; G2 = 0.2077 ± 0.0231 g; G3 = 0.1980 ± 0.0326 g; G4 = 0.1203 ± 0.0459 g; G5 = 0.2642 ± 0.0359 g. There were statistically significant differences among the groups (p<0.05); only dry heat sterilization was similar to the control. CONCLUSION: Sterilization by dry heat was the method that least affected the cutting capacity of the carbide burs and microwave sterilization was not better than traditional sterilization methods.
  • Assessment of canal walls after biomechanical preparation of root canals instrumented with protaper universalTM rotary system Original Articles

    Aguiar, Carlos Menezes; Mendes, Daniela de Andrade; Câmara, Andréa Cruz; Figueiredo, Antonio Poli de

    Resumo em Inglês:

    OBJECTIVE: The aim of this study was to examine the instrumented walls of root canals prepared with the ProTaper UniversalTM rotary system. MATERIAL AND METHODS: Twenty mesiobuccal canals of human first mandibular molars were divided into 2 groups of 10 specimens each and embedded in a muffle system. The root canals were transversely sectioned 3 mm short of the apex before preparation and remounted in their molds. All root canals were prepared with ProTaper UniversalTM rotary system or with NitiflexTM files. The pre and postoperative images of the apical thirds viewed with a stereoscopic magnifier (X45) were captured digitally for further analysis. Data were analyzed statistically by Fisher's exact test and Chi-square test at 5% significance level. RESULTS: The differences observed between the instrumented and the noninstrumented walls were not statistically significant (p<0.05). CONCLUSIONS: The NitiflexTM files and the ProTaper UniversalTM rotary system failed to instrument all the root canal walls.
  • CO2, Er: YAG and Nd:YAG lasers in endodontic surgery Original Articles

    Pozza, Daniel Humberto; Fregapani, Patrícia Wehmeyer; Xavier, Cristina Braga; Weber, João Batista Blessmann; Oliveira, Marília Gerhardt de

    Resumo em Inglês:

    OBJECTIVES: CO2, Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1% Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software®) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO2 laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO2 laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO2 laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO2 laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20%), B (17.24%) and F (17.84%). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.
  • Effect of relining on fiber post retention to root canal Original Articles

    Faria-e-Silva, André Luís; Pedrosa-Filho, Celso de Freitas; Menezes, Murilo de Sousa; Silveira, Daniele Machado da; Martins, Luís Roberto Marcondes

    Resumo em Inglês:

    One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem. OBJECTIVES: The aim of this study was to evaluate the effect of fiber post relining with composite resin on push-out bond strength. MATERIAL AND METHODS: Twenty bovine incisors were selected to assess post retention. The crowns were removed below the cementoenamel junction and the root canals were treated endodontically and flared with diamond burs. The roots were allocated into two groups (n=10): G1: fiber posts without relining and G2: fiber posts relined with composite resin. The posts were cemented with a dual-cured resin cement and the specimens were sectioned transversally. Three 1.5-mm thick slabs were obtained per root and identified as cervical, medium and apical thirds. The push-out test was performed at a crosshead speed of 0.5 mm/min until post dislodgement occurred. The failure mode of fractured specimens was analyzed under scanning electron microscopy. Data were analyzed by split-plot ANOVA and post-hoc Tukey's test at a pre-set alpha of 0.05. RESULTS: Relined fiber posts presented higher retention values than non-relined post in all thirds. No statistically significant differences (p>0.05) were found among thirds for relined posts. All failures occurred at the interface between resin cement and root dentin. CONCLUSIONS: Relining with composite resin seems to be an effective method to improve the retention of fiber posts to flared root canals.
  • Effect of immediate and delayed post space preparation on the apical seal of root canals obturated with different sealers and techniques Original Articles

    Aydemir, Hikmet; Ceylan, Gözlem; Tasdemir, Tamer; Kalyoncuoglu, Elif; Isildak, Ibrahim

    Resumo em Inglês:

    During mechanical preparation of the post space, the root canal filling may be twisted or vibrated, depending on several factors associated with the preparation technique and quality of filling. OBJECTIVE: The purpose of this study was to investigate the effect of immediate and delayed post space preparation on the integrity of the apical seal. MATERIAL AND METHODS: Sixty-four extracted human incisors were biomechanically prepared using the step-back technique. Sixty roots were randomly assigned to 6 experimental groups of 10 teeth each and the remaining 4 roots served as positive and negative controls (n=2). The root canals in the different groups were obturated with cold lateral and warm vertical condensation of gutta-percha and one of two sealers (Sealapex and Diaket). Post space was prepared either individually or simultaneously. An insulated copper wire was cut into 10-cm-long pieces. In each canal, one piece was inserted to maintain contact with gutta-percha and extended to the outside as one of two working electrodes. A stainless steel wire with the same dimensions of those of the copper wire, used as the other working electrode, was immersed into the background electrolyte from the center of the bottle. The electrical current between standard and experimental electrodes in canals was measured over a period of 10 days applying a conductivity meter. The Kruskal-Wallis test (p=0.05) determined whether there was a significant difference in microleakage among the groups and the Mann-Whitney U test (p=0.01) was used for multiple comparison grouping variables. RESULTS: The results suggest that only the differences between the root canal filling techniques were statistically significant (p<0.01). There were no statistically significant difference in the sealers and the times of filling removal for post space preparation (p>0.01). CONCLUSION: The quality of the root canal filling is important for the integrity of the apical seal.
  • Micromorphology and microhardness of enamel after treatment with home-use bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide Original Articles

    Sasaki, Robson Tetsuo; Arcanjo, Alex José; Flório, Flávia Martão; Basting, Roberta Tarkany

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to assess the effect of home-use bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide on enamel microhardness and surface micromorphology. MATERIAL AND METHODS: Enamel slabs (n=10) received the bleaching agents for 1 h/day and remained in artificial saliva solution for 23 h/day, during a total period of 21 days. Control group was composed of enamel slabs that were not subjected to treatment with the agents and were maintained in artificial saliva solution. Microhardness tests were performed before treatment application, 21 days of treatment and 14 days after the end of treatment. Scanning electron microscopy analyses were performed after 14 days after the end of bleaching treatment by 3 calibrated observers who attributed scores. RESULTS: The Tukey's test (α=0.05) showed no significant differences in microhardness values among bleaching agents, at 21 days of treatment and a significant increase in microhardness for different agents after 14 days from the end of treatment. Fisher's exact test showed differences in micromorphology of enamel between control and experimental groups (p=0.0342). CONCLUSIONS: Bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide may change surface micromorphology of enamel, although no changes in microhardness were observed.
  • Influence of post-cure treatments on hardness and marginal adaptation of composite resin inlay restorations: an in vitro study Original Articles

    Poskus, Laiza Tatiana; Latempa, Antonio Marcelo Accetta; Chagas, Maurício Alves; Silva, Eduardo Moreira da; Leal, Mariana Pareira da Silva; Guimarães, José Guilherme Antunes

    Resumo em Inglês:

    OBJECTIVES: The purpose of this study was to evaluate the Vickers hardness number (VHN) and the in vitro marginal adaptation of inlay restorations of three hybrid composite resins (Filtek Z250, Opallis and Esthet-X) subjected to two post-cure treatments. MATERIAL AND METHODS: For the microhardness test, three different groups were prepared in accordance with the post-cure treatments: control group (only light cure for 40 s), autoclave group (light cure for 40 s + autoclave for 15 min at 130ºC); and microwave group (light cure for 40 s + microwave for 3 min at 450 W). To assess the marginal adaptation, the composite resin was inserted incrementally into a mesial-occlusal-distal cavity brass mold and each increment light-cured for 40 s. A previous reading in micrometers was taken at the cervical wall, using a stereomicroscope magnifying glass equipped with a digital video camera and image-analysis software. Subsequently, the specimens were subjected to the post-cure treatments (autoclave and microwave) and a reading was taken again at the cervical wall. Data were compared using ANOVA for the hardness test, split-plot ANOVA for the adaptation assessment and Tukey's test for multiple comparisons. A significance level of 5% was adopted for all analyses. RESULTS: The post-cure treatments increased the hardness of conventional composites (p<0.001) and the gap values of inlay restorations (p<0.01). Filtek Z250 showed higher hardness (p<0.001) and lower gap values than Opallis and Esthet-X (p<0.05). Gap values did not exceed 90 µm for any of the experimental conditions. CONCLUSION: The post-cure treatments increased the VHN and the gap values on the cervical floor of composite resin inlays. Moreover, Filtek Z250 showed the best results, with higher hardness and lower gap values.
  • Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation Case Report

    Toygar, Hilal Uslu; Toygar, Okan; Guzeldemir, Esra; Cilasun, Ulkem; Nacar, Ahmet; Bal, Nebil

    Resumo em Inglês:

    Alport Syndrome (AS) is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.
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