Transferring ART research into education in Brazil

The aim of this study was to evaluate the teaching of the Atraumatic Restorative Treatment (ART) approach in Brazilian dental schools. MATERIALS AND METHODS: A questionnaire on this subject was sent to Pediatric Dentistry, Operative Dentistry and Public Health Dentistry professors. The questions approached the followig subjects: the method used to teach ART, the time spent on its teaching, under which discipline it is taught, for how many years ART has been taught and its effect on the DMFT index. RESULTS: A total of 70 out of 202 dental schools returned the questionnaire. The ART approach is taught in the majority of the Brazilian dental schools (96.3%), and in most of these schools it is taught both in theory and in clinical practice (62.9%). The majority (35.3%) of professors teach ART for 8 hours, and most often as part of the Pediatric Dentistry discipline (67.6%). It has been taught for the last 7 to 10 years in 34.3% of dental schools. Most professors did not observe a change in the DMFT index with this approach. There is a diversity in the teaching of ART in Brazil in terms of the number of hours spent, the teaching method (theory and practice), and the disciplines involved in its teaching. CONCLUSIONS: It is necessary to address the training of professors in the ART approach for the whole country. An educational model is proposed whereby a standard ART module features as part of other preventive and restorative caries care educational modules. This will facilitate and standardize the introduction and adoption of the ART approach in undergraduate education in Brazil

Influence of Erosive and Abrasive Cycling on Bonding of Diferent Adhesive Systems Enamel: An in situ study

This study evaluated the impact of orange juice on the bond strength (BS) of dentin bonding systems (DBSs) to enamel surface after simulation with an in situ/ ex vivo erosive cycling. One hundred and ninety two bovine enamel fragments (4x4x2 mm) were obtained and randomized regarding superficial microhardness and distributed to palatal devices for 8 volunteers, in three phases (one for each DBS), containing 8 blocks, which were, allocated in 4 pairs. Daily, these pairs were subjected extraorally to the following conditions: CONTneither erosive nor abrasive challenge; ERO- erosive challenge only; ABR- abrasive challenge only and ERO + ABR- with erosive and abrasive challenges. Erosive cycles (immersion in orange juice, 3 times/day/5 min/5 days) or/and abrasive challenges (electric toothbrush, 3 times/day/1 min/5 days) were performed. After these cycles, all specimens were restored with the adhesive systems Adper Scotchbond Multi Purpose (MP), Adper Single Bond 2 (SB) or Clearfil SE Bond (SE), and the composite resin Filtek Z250. After 7 days, sticks (area ≅1 mm2) were obtained and subjected to the microtensile bond strength test (μTBS) at 0.5 mm/min. Data was statistically analyzed by ANOVA and Tukey tests (a=0.05). Failure modes were determined using a digital microscope (40×). DBS was the only statistical significant factor. SE was the unique DBS not affected in any challenge, whereas MP and SB performed according to the scenario. The adhesive and mixed failures were predominant in all groups. Overall performance suggested that BS to enamel after erosive /abrasive challenged by orange juice was not affected and it was material-dependen

REABILITAÇÃO ESTÉTICA ATRAVÉS DE RESTAURAÇÃO DIRETA EM PACIENTE BRUXÔMANO: RELATO DE CASO

O bruxismo consiste num hábito parafuncional, apertamento excêntrico, que gera atrito entre os dentes antagonistas, podendo provocar alteração da dimensão vertical da oclusão (DVO) e desordens temporomandibulares (DTMs)

Ten-year survival of ART restorations in permanent posterior teeth

This study evaluated the 10-year clinical performance of high-viscosity glass-ionomer cement placed in posterior permanent teeth by means of the Atraumatic Restorative Treatment (ART) approach. One operator placed 167 single- and 107 multiple-surface restorations in 43 high-risk caries pregnant women (mean decayed teeth = 9.8 ± 5.5). Examinations were performed at 1-, 2-, and 10-year intervals according to ART criteria. In the last evaluation, the US Public Health Service (USPHS) criteria were also used. After 10 years, 129 restorations (47.1%) were evaluated and achieved a cumulative survival rate of 49.0% (SE 7.2%). The 10-year survival of single- and multiple-surface ART restorations assessed using the ART criteria were 65.2% (SE 7.3%) and 30.6% (SE 9.9%), respectively. This difference was significant (jackknife SE of difference; p < 0.05). Using the USPHS criteria, the 10-year survival of single- and multiple-surface ART restorations were 86.5% and 57.6%, respectively. The primary causes of failure were total loss (9.3%) and marginal defects (5.4%). The survival rates observed, especially for the single-surface restorations, confirm the potential of the ART approach for restoring and saving posterior permanent teeth

Resin modified glass ionomer cements evaluation with additional bioactive glass-ceramics nanoparticles

Os materiais bioativos são materiais sintéticos que possuem superfícies ativas em que os minerais presentes em tecidos duros podem se ligar quimicamente. Há alguns estudos em Odontologia, onde partículas desses materiais foram incorporadas aos Cimentos de Ionômero de Vidro (CIVs) e Cimentos de Ionômero de Vidro modificados por resina (CIVMRs) com o objetivo de se obter bioatividade, e conseqüente remineralização dentária. O presente estudo teve como objetivo avaliar os efeitos da incorporação de nanopartículas de vitrocerâmica bioativa nas propriedades de resistência à compressão e rugosidade de CIVMRs. Fuji II LC e Vitremer foram considerados os grupos controles. Materiais experimentais foram feitos através da incorporação de 2, 5 e 10% em peso de Biosilicato nestes CIVMRs. Seis corpos-de-prova de cada material foram confeccionados para o teste de resistência à compressão, que foi realizado em máquina de ensaios universal (Emic), a uma velocidade de 1,0 mm/min, depois de mantidos por 24 horas em água destilada a 37°C. Para análise da rugosidade, foram confeccionados dois corpos-de-prova de cada material, armazenados em água destilada por sete dias, para terem suas superfícies analisadas por meio de Microscopia de Força Atômica. Os dados da resistência à compressão e rugosidade foram submetidos à análise estatística por meio da Análise de Variância (ANOVA) a dois critérios e para comparações múltiplas foi aplicado o teste de Tukey, com nível de significância de 5%. Apenas os cimentos com 2% de nanopartículas de vitrocerâmica bioativa obtiveram resistência à compressão semelhante ao grupo controle, as demais concentrações contribuíram para a diminuição dessa resistência. A incorporação de 5% de nanopartículas de vitrocerâmica bioativa aumentou a rugosidade superficial dos CIVMRs estudados.Bioactive materials are synthetic materials that have active surfaces that are capable to chemically bond to dental structures. There are some studies where particles of these materials were incorporated in Glass-ionomer cements (GIC) and Resin-modified glass-ionomer cements (RMGIC) trying to achieve bioactivity and dental remineralization. The aim of this study was to evaluate the effects of the incorporation of bioactive glass-ceramics nanoparticles on the compressive strength and roughness of RMGIC. Fuji II LC and Vitremer were considered the control groups. Experimental materials were made adding 2, 5 and 10% (weight) of Biosilicate into these RMGIC. Six specimens of each material were made to be tested on compressive strength performed with a universal testing machine (Emic) at a crosshead speed of 1.0 mm / min, after they were stored in distilled water for 24 hour at 37°C. To roughness analysis, two specimens of each material were made and stored in distilled water for 7 days and their surfaces were analyzed with a Atomic Force Microscope. Data of compressive strength and roughness were statistically analyzed by ANOVA and Tukey test for multiple comparisons. Only the RMGICs with 2% of bioactive glass-ceramic nanoparticles obtained compressive strength similar to the control RMGICs, the other concentrations decreased their compressive strength values. The incorporation of 5% of bioactive glass-ceramic nanoparticles increased the roughness of the RMGICs

Efffect of a resinous infiltrant on the tratment of white spot lesions: in vitro and in situ analysis

Dentre as estratégias de tratamento de lesões incipientes de cárie, no estágio de mancha branca ativa, o infiltrante resinoso tem sido empregado, preenchendo os poros do esmalte e impedindo a sua progressão. O objetivo deste trabalho foi avaliar o efeito do infiltrante de cárie (Icon®) sobre lesões cariosas artificiais produzidas por diferentes protocolos e a eficiência deste tratamento após novo desafio ácido por modelos experimentais in vitro e in situ, utilizando a microdureza de superfície (MS) e longitudinal (ML). Na fase in vitro, lesões cariosas artificiais foram produzidas em 45 espécimes de esmalte bovino (6x4mm) através de três diferentes protocolos (ciclagem DES-RE, gel MC e solução MHDP). Os espécimes foram tratados com o infiltrante e submetidos a novo desafio ácido por ciclagem DES-RE. Este delineamento resultou em 4 condições em um mesmo espécime: hígida (H), após a desmineralização (D), após o tratamento com o infiltrante (I) e após o novo desafio ácido (N). Na fase in situ, 15 voluntários usaram dispositivos palatinos contendo dois espécimes por 14 dias, induzindo a lesão por meio de gotejamento de solução de sacarose 8x/dia. Nas duas fases, a MS e ML foram avaliadas em todas as condições dos espécimes até 220&#x3BC;m. Os dados foram coletados e processados pela porcentagem da diferença com os valores iniciais da condição hígida para serem analisados estatisticamente de acordo com ANOVA (medidas repetidas) e teste de Tukey (p<0,05). No estudo in vitro e in situ todos os protocolos de desmineralização foram capazes de produzir lesões de cárie de subsuperfície. Todos os protocolos in vitro promoveram perda de dureza de superfície maior que 75%, enquanto o protocolo in situ promoveu quase 40%. Há uma redução da perda de dureza à medida que a profundidade aumenta em todos os casos, sendo as particularidades mais observadas até 50 &#x3BC;m. O infiltrante avaliado em todas as condições foi capaz de re-equilibrar parcialmente a dureza interna, entretanto sua resistência e efeito após o novo desafio ácido apresentou-se limitado.Among the strategies for early caries lesions treatment as active white spot, the resin infiltrant has been employed filling the enamel pores and preventing their progression. The aim of this study was to evaluate the effect of caries infiltrant (Icon®) on artificial carious lesions produced by different protocols, and the efficiency of this treatment after new challenge acid by in vitro and in situ experimental models, using the surface microhardness (SH) and cross-sectional microhardness (CSH). In the in vitro phase, artificial carious lesions were performed on 45 enamel bovine specimens (6x4mm) by three different protocols (DE-RE cycling, MC gel and MHDP solution). The specimens were treated with the infiltrant and subjected to a new challenge by DE-RE cycling. This design resulted in four conditions at the same specimen: sound (S), after demineralization (D), after the treatment with infiltrant (I) and after the new acid challenge (N). In the in situ phase, 15 volunteers wore intraoral appliances containing two specimens for 14 days, inducing the lesion formation by sucrose solution dripping 8x/day. In both models, SH and CSH were evaluated in all conditions of the specimens up to 220&#x3BC;m. Data were collected and processed as percentage from the difference to each condition compared to sound stage to be statistically analyzed with ANOVA (repeated measures) and Tukey test (p <0.05). For all tested conditions, demineralization protocols were able to produce subsurface carious lesions. All in vitro protocols promoted hardness loss higher than 75% while in situ protocol promoted almost 40%. There is a reduction in the hardness loss as the depth increases, in which the main differences can be noticed up to 50&#x3BC;m. The infiltrant evaluated in all conditions was able to partially re-balance the internal hardness, however its strength and effect after the new challenge acid had been limited

Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up

<div><p>Abstract Objective This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. Material and Methods A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Results Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Conclusions Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.</p></div