Influence of mandibular and palatal intraoral appliances on erosion in situ study outcome

The standardization of in situ protocols for dental erosion is important to enable comparison between studies. Objective: Thus, the objectives of this study were to evaluate the influence of the location of in situ intraoral appliance (mandibular X palatal) on the extent of enamel loss induced by erosive challenges and to evaluate the comfort of the appliances. Material and Methods: One hundred and sixty bovine enamel blocks were selected according to their initial surface hardness and randomly divided into two groups: GI - palatal appliance and GII - mandibular appliance. Twenty volunteers wore simultaneously one palatal appliance (containing 4 enamel blocks) and two mandibular appliances (each one containing 2 enamel blocks). Four times per day during 5 days, the volunteers immersed their appliances in 0.01 M hydrochloric acid for 2 minutes, washed and reinserted them into the oral cavity for 2 hours until the next erosive challenge. After the end of the in situ phase, the volunteers answered a questionnaire regarding the comfort of the appliances. The loss of tissue in the enamel blocks was determined profilometrically. Data were statistically analyzed by paired t-test, Chi-square and Fisher's Exact Test (p<0.05). Results: The enamel blocks allocated in palatal appliances (GI) presented significantly higher erosive wear when compared to the blocks fixed in mandibular appliances (GII). The volunteers reported more comfort when using the palatal appliance. Conclusions: Therefore, the palatal appliance is more comfortable and resulted in higher enamel loss compared to the mandibular one

Desempenho de resinas compostas a base de giomer submetidas ao desgaste erosivo e sua influência na alteração do esmalte adjacente: estudo in vitro

Erosive tooth wear is the permanent loss of hard dental tissue by the frequent action of chemical and mechanical challenges. This condition has shown an increase in its prevalence in recent years, requiring intervention in the process, ideally through preventive therapies, however, these lesions often need restorative therapies. The objective of this study was to test the use of Giomer-based resins under conditions of erosive tooth wear and its effect on adjacent enamel compared to conventional composite resin and glass ionomer cement by means of an in vitro evaluation, leading to taking into account its differentiated recharge and fluoride release technology, satisfactory aesthetics and resistance and its ability to neutralize acid pH. For that, 120 specimens of bovine teeth were obtained, selected and randomly distributed in 12 groups (n = 10): GI: Composite Nano-Hybrid Resin with Giomer technology (EROSION); GII: Composite Nano-Hybrid resin with Giomer technology (EROSION + ABRASION); GIII: Resin Composed of single increment with Giomer technology (EROSION); GIV: Composite resin of single increment with Giomer technology (EROSION + ABRASION); GV: Micro-Hybrid Composite Resin (EROSION); GVI: Micro-Hybrid Composite Resin (EROSION + ABRASION); GVII: Single-increment Micro-Hybrid Composite Resin (EROSION); GVIII: Single-increment Micro-Hybrid Composite Resin (EROSION + ABRASION); GIX: Conventional Glass Ionomer Cement - CIVC (EROSION); GX: Conventional Glass Ionomer Cement - CIVC (EROSION + ABRASION); GXI: Resin Modified Glass Ionomer Cement - CIVMR (EROSION); GXII: Resin Modified Glass Ionomer Cement - CIVMR (EROSION + ABRASION). In each enamel specimen a cavity was made and the restorative material was inserted under study according to the manufacturer\'s specifications. The initial profile was then performed, with scans of the material and the adjacent enamel (at 100, 200, 300, 600 and 700m). During 5 days, 6 erosive challenges were performed with citric acid for 2 minutes and in the EROSION + ABRASION groups the brushing was performed for 1 minute in a simulated brushing machine, immediately after erosion and washing. Subsequently the final profile was made in the same locations of the initial, for graphic overlap and analysis of loss of material and enamel. The data were evaluated for normality and homogeneity by two-way ANOVA and then the Tukey test was used for comparison between groups, considering p <0,05. When subjected to erosion, the GIX and GXI groups presented greater loss of material compared to the other groups. Up to 300m away from the restoration, the GIC groups and Giomer-based resins were able to promote less enamel loss than the conventional resin. For erosion associated with abrasion, Giomer-based resins showed intermediate loss of material, with greater loss in ionomeric groups and lower loss in conventional resin, with no difference between adjacent enamel in these conditions. It was concluded that Giomer-based resins are a good alternative for restorative treatment of erosion lesions.O desgaste dentário erosivo é a perda permanente de tecido dental duro pela ação frequente de desafios químico e mecânico. Essa condição vem apresentando um aumento na sua prevalência nos últimos anos, necessitando intervenção no processo idealmente por meio de terapias preventivas, entretanto, muitas vezes essas lesões necessitam de terapias restauradoras. O objetivo deste estudo foi testar a utilização de resinas a base de tecnologia Giomer, sob condições de desgaste dentário erosivo e seu efeito no esmalte adjacente em comparação com a resina composta convencional e cimento de ionômero de vidro por meio de uma avaliação in vitro, levando em conta sua tecnologia diferenciada de recarga e liberação de flúor, estética e resistência satisfatórias e sua capacidade de neutralizar o pH ácido. Para tanto, 120 espécimes de dentes bovinos foram obtidos, selecionados e randomicamente distribuídos em 12 grupos (n=10): GI: Resina Composta Nano-Híbrida com tecnologia Giomer (EROSÃO); GII: Resina Composta Nano-Híbrida com tecnologia Giomer (EROSÃO + ABRASÃO); GIII: Resina Composta de incremento único com tecnologia Giomer (EROSÃO); GIV: Resina Composta de incremento único com tecnologia Giomer (EROSÃO + ABRASÃO); GV: Resina Composta Micro Híbrida (EROSÃO); GVI: Resina Composta Micro Híbrida (EROSÃO + ABRASÃO); GVII: Resina Composta Micro Híbrida de incremento único (EROSÃO); GVIII: Resina Composta Micro Híbrida de incremento único (EROSÃO + ABRASÃO); GIX: Cimento de Ionômero de Vidro Convencional - CIVC (EROSÃO); GX: Cimento de Ionômero de Vidro Convencional CIVC (EROSÃO + ABRASÃO); GXI: Cimento de Ionômero Vidro Modificado por Resina CIVMR (EROSÃO); GXII: Cimento de Ionômero Vidro Modificado por Resina CIVMR (EROSÃO + ABRASÃO). Em cada espécime de esmalte foi confeccionada uma cavidade e inserido o material restaurador em estudo de acordo com as especificações do fabricante. A seguir foi realizado o perfil inicial, com varreduras no material e no esmalte adjacente (a 100, 200, 300, 600 e 700m). Durante 5 dias foram realizados 6 desafios erosivos com ácido cítrico durante 2 minutos e, posteriormente, nos grupos EROSÃO + ABRASÃO foi realizada a escovação por 1 minuto em uma máquina de escovação simulada, imediatamente após a erosão e lavagem. Posteriormente foi feito o perfil final nos mesmos locais do perfil inicial, para sobreposição gráfica e análise de perda de material e esmalte. Os dados foram avaliados quanto à normalidade e homogeneidade por meio do teste ANOVA a dois critérios e então foi feito o teste de Tukey para comparação entre os grupos, considerando p<0,05. Quando submetido à erosão, os grupos GIX e GXI apresentaram maior perda de material comparado aos outros grupos. Até 300m de distância da restauração, os grupos de CIV e resinas a base de Giomer foram capazes de promover menor perda de esmalte que a resina convencional. Para erosão associada à abrasão, resinas a base de Giomer demonstraram perda de material intermediária, sendo vista uma maior perda nos grupos ionoméricos e menor perda na resina convencional, não havendo diferença entre o esmalte adjacente nessas condições. Conclui-se que resinas a base da tecnologia Giomer são uma boa alternativa para o tratamento restaurador de lesões de erosão

Localized Bone Loss Resulted from an Unlikely Cause in an 11-Year-Old Child

Periodontal diseases have several causes, amongst them, by foreign bodies. In this case report, an 11-year-old child who lived in a rural area and has never been treated by a dentist presented an extensive horizontal bone loss and edema on the region of tooth 44. The diagnosis of foreign body was obtained after biopsy, since an elastic band around the middle of the root tooth was found. The elastic band was not radiopaque, and the patient did not inform that she found the elastic band on the floor of the school and introduced the tooth by herself. Based on the case reported, it is concluded that anamnesis and clinical and radiographic examination are fundamental strategies to obtain the diagnosis, but sometimes, especially in children, there may be inconsistencies that can be elucidated by a biopsy

Influence of mandibular and palatal intraoral appliances on erosion in situ study outcome

Abstract The standardization of in situ protocols for dental erosion is important to enable comparison between studies. Objective: Thus, the objectives of this study were to evaluate the influence of the location of in situ intraoral appliance (mandibular X palatal) on the extent of enamel loss induced by erosive challenges and to evaluate the comfort of the appliances. Material and Methods: One hundred and sixty bovine enamel blocks were selected according to their initial surface hardness and randomly divided into two groups: GI - palatal appliance and GII - mandibular appliance. Twenty volunteers wore simultaneously one palatal appliance (containing 4 enamel blocks) and two mandibular appliances (each one containing 2 enamel blocks). Four times per day during 5 days, the volunteers immersed their appliances in 0.01 M hydrochloric acid for 2 minutes, washed and reinserted them into the oral cavity for 2 hours until the next erosive challenge. After the end of the in situ phase, the volunteers answered a questionnaire regarding the comfort of the appliances. The loss of tissue in the enamel blocks was determined profilometrically. Data were statistically analyzed by paired t-test, Chi-square and Fisher's Exact Test (p<0.05). Results: The enamel blocks allocated in palatal appliances (GI) presented significantly higher erosive wear when compared to the blocks fixed in mandibular appliances (GII). The volunteers reported more comfort when using the palatal appliance. Conclusions: Therefore, the palatal appliance is more comfortable and resulted in higher enamel loss compared to the mandibular one