In vitro dentin permeability after application of Gluma® desensitizer as aqueous solution or aqueous fumed silica dispersion

OBJECTIVES: To assess and to compare the effects of Gluma® Desensitizer (GDL) with an experimental glutaraldehyde and HEMA containing fumed silica dispersion (GDG) on dentin permeability using a chemiluminous tracer penetration test. MATERIAL AND METHODS: Twenty disc-shaped dentin specimens were dissected from extracted human third molars. The dentin specimens were mounted in a split chamber device for determination of permeability under liquid pressure using a photochemical method. Ten specimens were randomly selected and allocated to the evaluation groups Gluma® Desensitizer as aqueous solution and glutaraldehyde/HEMA as fumed silica dispersion, respectively. Dentin disc permeability was determined at two pressure levels after removal of smear with EDTA, after albumin soaking, and after application of the desensitizing agents. Two desensitizer-treated and rinsed specimens of each group were examined by scanning electron microscopy (SEM) for surface remnants. RESULTS: Comparatively large standard deviations of the mean EDTA reference and albumin soaked samples permeability values refected the differences of the dentin substrates. The mean chemiluminescence values of specimen treated with GDL and GDG, respectively, were signifcantly reduced after topical application of the desensitizing agents on albumin-soaked dentin. The effects of GDL and GDG on permeability were not signifcantly different. Treated specimens showed no surface remnants after rinsing. CONCLUSIONS: The experimental desensitizer gel formulation reduced dentin permeability as effectively as the original Gluma® Desensitizer solution

Odontoiatria basata sull\u2019evidenza e linee guida: come trasferire gli interventi efficaci nella pratica clinica.

Vengono discussi alcuni dei pi\uf9 importanti aspetti relativi ai clinical trial, in particolare la natura comparativa, la necessit\ue0 di randomizzazione e la possibilit\ue0 di mascheramento. Ulteriori osservazioni riguardano la minima differenza clinica importante e il punto chiave delle distorsioni sistematiche. Le linne guida devono rappresentare gli strumenti per supportare le decisioni cliniche, rafforzando la competenza

Odontoiatria basata sull\u2019evidenza

L'EBM si fonda sugli studi osservazionali prospettici, come gli studi di coorte e sulle ricerche cliniche sperimentali. I RCT rappresentano la migliore possibilit\ue0 di una ricerca con il massimo controllo delle distorsioni.. Le difficolt\ue0 di analisi della vastissima letteratura rendono indispensabili le Rassegne Sistematiche, che sono collocate al primo posto della gerachia dell'evidenza

RESTORATION OF CERVICAL LESIONS:7-YEAR RESULTS OF A RCT

A randomized controlled trial represents the best solution for checking the clinical performances. Objectives: The aim of the study was to test two all-in-one bonding systems vs a 3-step E&R in cervical abrasion/erosion lesions with the null-hypothesis of no difference between the three bonding systems. Methods: A randomized controlled trial was scheduled on 50 patients, 22 males, 28 females, aged between 30-52, with 3 cervical lesions, respecting the inclusion-exclusion and randomisation criteria for selection of technique and teeth. The materials selected were i-Bond(H) (Heraeus-Kulzer), AQ bond (S)(Morita)and SBMP (M)(3M-ESPE)as control. The procedure was done by 3 operators with 8,4,4-year of experience, all the cavities were restored with Z250 (3M-ESPE), using a layering technique and soft start light-curing with an halogen lamp (Visilux 3000, 3M), with 400 mW/cm2,with a final energy density > 8 J/cm2. The diameter, the depth, the type of dentin and the margin location of the lesions were recorded. ANOVA statistical analysis (P=0.05) was performed. The restorations were evaluated by an examiner with an intra-agreement > .80 with a loop (4.5x) according with USPHS modified criteria at baseline, 6,12,24,36,60,72,84 months. Results: After 84 months 42 patients were assessed: the group S showed 14 failures with 10 restorations lost and 4 rated Charlie for margin infiltration, the group H had 7 failures, with 2 restorations lost and 5 rated Charlie for marginal infiltration, the group M had 6 failures with 1 restoration lost and 5 rated Charlie for marginal infiltration. There is a significant difference between the group S and groups H and M (P=.03), no difference between H and M. Conclusions: Within the limits of this clinical trial, the null hypothesis was partially rejected, because only one all-in-one bonding system works as well as a three step bonding agent