Multi-Mode adhesives performance and success/retention rates in NCCLs restorations: randomised clinical trial one-year report

Aim: Compare clinical performance and success/retention rates of two multi-mode (MM) adhesives, applied in self-etch (SE) or etch-and-rinse (ER) modes, with SE-all-in-one adhesive (SE/SE with enamel etching) in NCCL restorations at one-year follow-up. Material and methods: Prospective, double-blind RCT approved by the University Fernando Pessoa and the National-Clinical-Research-Ethics Committees (CEIC-20150305), ClinicalTrials.gov registered (NCT02698371), in 38 participants with 210 restorations (AdmiraFusionVR ) randomly allocated to six groups (Adhesives_Adhesion mode), each with 35 restorations: G1-Control FuturabondVRDC_SE; G2-Control FuturabondVRDC_SE with enamel etching; G3-FuturabondVRU_ER; G4-FuturabondVR U_SE; G5-AdheseVR Universal_ER; G6-AdheseVR Universal_SE. Restorations evaluated at baseline and one-year by three calibrated examiners (ICC 0.952) using FDI criteria and statistical analysis with nonparametric tests (alpha=0.05). Results: At one-year recall 36 participants, 199 restorations were available for examination; five (2.5%) restorations (G1 n=2; G2, G3, G4 n=1) were lost due to retention (p>.05); G1 showed less satisfying marginal adaptation (p<.05) than G2 and MM adhesives groups, particularly G6. Overall success rates (p>.05) were: 93.9% (G1), 97.0% (G2; G3; G4) and 100.0% (G5; G6). Conclusions: MM adhesives (FuturabondVRU and AdheseVR Universal) showed similar and acceptable performance/success rates but also better clinical outputs than the SE-all-in-one adhesive (FuturabondVR DC), particularly in SE mode. Success and retention rates were similar and not dependent on materials or adhesion modes.Fundacão Fernando Pessoa, Porto, Portugalinfo:eu-repo/semantics/publishedVersio

Aesthetic preference in the transverse orientation of the occlusal plane in rehabilitation: perspective of Laypeople and dentists

The present study had a convenience sample with 236 laypeople and 242 dentists who completed an online questionnaire to choose the most attractive image among six pairs for comparison. Control image: symmetric (parallelism between occlusal plane (OP), commissural line (CL), and interpupillary line (IL)). Change of Control, obtaining three images with a 3-degree inclination of the labial commissures. Image A: OP parallel to IL; Image B: OP parallel to CL; Image C: OP at 1.5 degree mean angulation between IL and CL. Non-parametric comparison (IBM© SPSS Statistics vs. 27.0, p A > C > B (p A > (C not ≠ B). Dentists significantly prefer more the Control and Image A than laypeople (p < 0.001). Sex (single exception in laypeople), age, and dentist’s area of activity did not interfere in the perception of attractiveness. Dentists and laypeople preferred the Control when compared to images with CL canted. In the existence of CL inclination, the preference of the groups was the IL as a reference for OP orientation, with the mean angulation or coincident with the CL being considered less aesthetic.info:eu-repo/semantics/publishedVersio

Odontogeriatria: Conhecer para ajudar

Um dos critérios para a identificação de um idoso bem sucedido é a manutenção, durante toda a vida, de uma dentição natural, saudável e funcional, incluindo todos os aspectos sociais e benefícios biológicos, tais como a estética, conforto, capacidade para mastigar, sentir sabor e falar. A fraca Saúde Oral dos idosos tem sido particularmente evidente através de elevados níveis de perdas dentárias, doença periodontal, cáries, xerostomia, lesões da mucosa associadas ao uso de próteses dentárias mal adaptadas e cancro oral. A prevenção é uma aposta neste grupo etário e alguns aspectos, como o controlo da placa bacteriana, uso de agentes antimicrobianos, uso de flúor nas mais diversas formas de apresentação e uma dieta adequada, são os métodos a preconizar. O impacto negativo das fracas condições orais na qualidade de vida dos idosos é um importante problema de Saúde Pública, que deve ser tratado a vários níveis e valorizado pelos responsáveis nacionais pelos programas de saúde

Bacterial contamination of gutta-percha points from different brands and the efficacy of a chairside disinfection protocol

Objective: To evaluate the bacterial contamination of different brands of Gutta-Percha (GP) points routinely used in clinical practice and the efficacy of a chairside disinfection protocol with sodium hypochlorite. Methods: GP points (n=240), in sizes A, B, C, D, K15, K20, K25, K30, K35, K40, F1, F2, F3 (Dentsply®, Proclinic®, ProTaper® and R&S®), were randomly sampled from commercial packages already in use. These were added directly to Fluid Thioglycolate Medium (one GP point per tube) and incubated at 37ºC for 21 days. During this period, the presence/absence of turbidity was evaluated. To evaluate the efficacy of a chairside disinfection protocol, all detected contaminated GP points were immersed for 1 minute in 10 mL of 5.25% sodium hypochlorite, followed by 5 minutes in 10 mL of detergent solution (3% Tween 80 and 5% sodium thiosulfate) and a final rinse with 10 mL of sterile distilled water and incubated. The data was analysed using the chi-square test and differences between characteristics of dichotomic variables were performed using the binomial test. The significance level was set at P<0.05. Results: Bacterial growth was observed in 22.9% of the total study samples. Dentsply® and R&S® showed the highest level of contamination, 47.3% each, although without significant differences to the other commercial brands. The most contaminated GP point size was K30 (16.4%). The chairside disinfection protocol was effective in disinfection of 76.4% of GP points (P<0.001). Conclusion: A real small number of GP points in clinical use harboured bacteria, including after the Chairside Disinfection Protocol that, anyway, proved to be effective. No significant difference was observed between tested commercial brands.info:eu-repo/semantics/publishedVersio

Detection of Staphylococcus aureus (MRSA/MSSA) in surfaces of dental medicine equipment

Methicillin-Resistant Staphylococcus aureus (MRSA) represents one of the major causes of nosocomial infections, leading to high mortality. Surfaces in clinics, as well as the attending uniform and the hands of the dental doctor can be MRSA reservoirs. Having this in mind, the purpose of this study was to evaluate the presence of Methicillin-Sensitive Staphylococcus aureus (MSSA) and MRSA on dental medicine equipment surfaces. 354 Samples were collected from six equipment surfaces in six attendance areas before and after patient consultation and cultured in a selective medium. Polymerase Chain Reaction (PCR) was used to confirm the identity of bacterial strains as MRSA or MSSA. Data analysis was performed with chi-square tests with Bonferroni correction. It was observed 55.6% of uncontaminated samples. Contamination was: 17.5% MRSA (5.9% of samples collected before patient attendance and 11.6% after); 39.3% MSSA (14.1% collected before and 25.2% after). The prevalence of MRSA and MSSA was significantly higher after patient care. Integrated Clinic represented the most contaminated attendance area (MRSA 41.7%, MSSA 51.2%), the chair arm rest was the most contaminated surface for MRSA (29.7%) and the dental spittoon the most contaminated surface for MSSA (23.5%). Although a low level of contamination was observed, dental clinics, through patients possibly carrying bacteria, may be reservoirs for MRSA and MSSA transmission, and might contribute to potential nosocomial infections.info:eu-repo/semantics/publishedVersio

Avaliação do estado de saúde oral em idosos institucionalizados e estudo das repercussões do uso de próteses removíveis desadaptadas nos tecidos dentários

Tese de Doutoramento apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Doutor em Biotecnologia e Saúde, Epidemiologia e Saúde Pública.A grande heterogeneidade entre os idosos tem originado algumas dúvidas sobre o conceito de normalidade no estado de saúde oral. Este estudo de investigação pretende avaliar as condições de saúde oral de uma população institucionalizada e as repercussões das próteses nos tecidos dentários, quando não devidamente adaptadas ou controladas. Foram seleccionados de forma aleatória 372 idosos residentes em Lares do Distrito do Porto. Foi realizado um questionário para caracterizar a amostra relativamente a alguns aspectos, entre eles, os hábitos de higiene oral. Observou-se a cavidade oral, registando o IP (Índice de Placa), o CPO (Cariados, Perdidos, Obturados), o ICR (Índice de Cárie Radicular), o CPI (Índice Periodontal Comunitário), o tipo de desdentação, o estado dos dentes pilar e a presença de prótese. Sendo portador, era avaliado o estado da prótese e realizado outro questionário sobre higiene das próteses, anos de uso e quem as confeccionou. A média de idades da amostra foi 78,8 (±9,1) anos, com um CPO de 25,6 (±7,3) e em que 15,1% dos idosos tinham 20 ou mais dentes. Dos 30.9% de desdentados totais, 5,9% não estavam reabilitados. A prevalência de cárie radicular foi 78,6% e no CPI registaram-se apenas 2,9% de sextantes sãos e 63,8% sextantes excluídos. Dos dentados, 38,9% não escovava os seus dentes. Apenas 34,0% dos pilares dos portadores de próteses estavam sãos. A estabilidade e a retenção da prótese, apresentaram-se negativamente associadas às próteses acrílicas totais. Em análise multivariada (regressão logística) verificou-se que ter 20 ou mais dentes estava significativamente e independentemente associado com a escovagem e grau de escolaridade. A probabilidade de ter um ICRi ≥ 20,0% aumenta 2,8 vezes nos que não escovam e 5,3 vezes nos portadores de próteses esqueléticas face aos restantes idosos. A higiene da prótese verificou-se ser um factor explicativo para a existência de lesão nos dentes pilares. Nesta população, urge que as instituições implementem medidas preventivas efectivas e que haja um melhor acompanhamento Médico-Dentário para minorar as necessidades de tratamento e reabilitação. The vast heterogeneity amongst elderly people has given rise to certain doubts concerning the concept of normality in the oral health status. This research study aims to evaluate the oral health conditions of an institutionalized population, as well as the repercussions of the prosthesis upon dental tissues, when not dully fitted or controlled. A random selection of 372 elderly people living in Nursing Homes from the Oporto District was performed. A questionnaire was done, in order to characterize the sample in relation to some aspects, one of them being oral hygiene. The oral cavity was observed, with a consequent record of the PI (Plaque Index), the DMFT (Decayed, Missing, Filled Teeth), the RCI (Root Caries Index), the CPI (Community Periodontal Index), type of edentulism, the status of the abutment teeth and the presence of a prosthetic appliance. If one was a bearer, the prosthesis status was evaluated, and another questionnaire performed, concerning prosthetic hygiene, usage years and its manufacturer. The average age of the sample was 78.8 years (±9.1), with a DMFT of 25.6 (±7,3) and 15.1% of the elderly people having 20 or more teeth. From the 30.9% of total edentule, 5.9 were not rehabilitated. The radicular caries prevalence was of 78.6% and, as to what concerns the CPI, only 2.6% of the sextants were considered healthy, the remaining 68.8% of the sextants being excluded. In the teethed sample, 38.9% did not brush their teeth. Only 34.0% of the prosthesis abutments were healthy. The prosthesis stability, alongside with its retention, were negatively associated with full acrylic dentures. Using multivariate analysis (logistic regression), it was ascertained that those who possessed 20 or more teeth were significant and independently associated with brushing and literacy. The chance of having an RCIi of ≥ 20.0% increases 2.8 times amongst the non-brushing section and 5.3 times in the metal casted prosthesis bearers, in relation with the rest of the elders. The prosthesis hygiene was verified as being an explanatory factor for the existence of the abutment teeth lesions. In relation with this population, it is urgent the institutions implement effective preventive measures as well as a better dental follow-up, in order to decrease the need for treatment and rehabilitation. La grande hétérogénéité parmi la population âgée a causé certains doutes en ce qui concerne le concept de normalité de l’état du statut orale. Cet étude d’investigation possède l´objectif d’évaluer les conditions de la santé orale d’une population âgée institutionnalisée, ainsi que les répercussions de prosthèses dans les tissues dentaires, quand elles ne sont pas correctement adaptées ou contrôlées. Nous avons fait une sélection aléatoire de 372 personnes âgées qui vivaient dans des Maisons de Retraite, de la région du Porto. Nous avons fait un enquête pour caractériser le spécimen relativement à certains aspects, un d’entre eux étant l’hygiène orale. Nous avons fait l’observation de la cavité buccale, avec un postérieur enregistrement du IP (Indice Parodontal), du ICAO (Cariées, Absentes, Obturées), du ICR (Indice de Carie Radiculaire), du ICBTP (Indice Communautaire des Besoins en Traitements Parodontaux) le type d’édenté, le statut des dents de contrefort et la présence d’un appareil prosthétique. Si quelqu’un en possédait une, le statut de la prosthèse était évalué et un autre enquête était fait, ceci concernant l’hygiène prosthétique, les années d’utilisation et son fabricant. L´âge moyen du spécimen était de 78.8 ans (±9.1), avec un ICAO de 25.6, dans lequel 15.1% des personnes âgées possédait 20 dents ou encore plus. Des 30.9% des personnes totalement édentés, 5.9% n’était pas réhabilité. La prévalence des caries radiculaires était de 78.6% et, en ce qui concerne le ICBTP, seulement 2.6% des sextants ont été considéré sains, ce qui signifiait que les autres 68.8 % des sextants ont été exclus. Parmi le spécimen denté, 38.9% ne brossait pas leurs dents. Seulement 34.0% des contreforts prosthétiques étaient sains. La stabilité des prosthèses, ainsi que sa rétention, ont été négativement associées aux prosthèses acryliques totales. En relation aux modèles de régression logistique, nous avons vérifié que ceux qui possédait 20 dents ou encore plus devait ça, significative et absolument, au brossage et à la scolarité. La chance d’avoir un ICRi de ≥ 20.0% augmente 2.8 fois parmi le spécimen qui ne brossait pas les dents et 5.3 fois parmi ceux qu’utilisaient des prosthèses en métal, en comparaison avec les autres personnes âgées. L’hygiène de la prosthèse a été considérée comme un facteur explicatif pour l’existence de lésions dans les dents contreforts. Dans cette population, il est urgent que les Institutions installent des mesures préventives efficaces, aussi qu’un meilleur accompagnement dentaire pour minorer les nécessités de traitement et réhabilitation

Avaliação do estado de saúde oral em idosos institucionalizados e estudo das repercussões do uso de próteses removíveis desadaptadas nos tecidos dentários

Tese de Doutoramento apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Doutor em Biotecnologia e Saúde, Epidemiologia e Saúde Pública.A grande heterogeneidade entre os idosos tem originado algumas dúvidas sobre o conceito de normalidade no estado de saúde oral. Este estudo de investigação pretende avaliar as condições de saúde oral de uma população institucionalizada e as repercussões das próteses nos tecidos dentários, quando não devidamente adaptadas ou controladas. Foram seleccionados de forma aleatória 372 idosos residentes em Lares do Distrito do Porto. Foi realizado um questionário para caracterizar a amostra relativamente a alguns aspectos, entre eles, os hábitos de higiene oral. Observou-se a cavidade oral, registando o IP (Índice de Placa), o CPO (Cariados, Perdidos, Obturados), o ICR (Índice de Cárie Radicular), o CPI (Índice Periodontal Comunitário), o tipo de desdentação, o estado dos dentes pilar e a presença de prótese. Sendo portador, era avaliado o estado da prótese e realizado outro questionário sobre higiene das próteses, anos de uso e quem as confeccionou. A média de idades da amostra foi 78,8 (±9,1) anos, com um CPO de 25,6 (±7,3) e em que 15,1% dos idosos tinham 20 ou mais dentes. Dos 30.9% de desdentados totais, 5,9% não estavam reabilitados. A prevalência de cárie radicular foi 78,6% e no CPI registaram-se apenas 2,9% de sextantes sãos e 63,8% sextantes excluídos. Dos dentados, 38,9% não escovava os seus dentes. Apenas 34,0% dos pilares dos portadores de próteses estavam sãos. A estabilidade e a retenção da prótese, apresentaram-se negativamente associadas às próteses acrílicas totais. Em análise multivariada (regressão logística) verificou-se que ter 20 ou mais dentes estava significativamente e independentemente associado com a escovagem e grau de escolaridade. A probabilidade de ter um ICRi ≥ 20,0% aumenta 2,8 vezes nos que não escovam e 5,3 vezes nos portadores de próteses esqueléticas face aos restantes idosos. A higiene da prótese verificou-se ser um factor explicativo para a existência de lesão nos dentes pilares. Nesta população, urge que as instituições implementem medidas preventivas efectivas e que haja um melhor acompanhamento Médico-Dentário para minorar as necessidades de tratamento e reabilitação. The vast heterogeneity amongst elderly people has given rise to certain doubts concerning the concept of normality in the oral health status. This research study aims to evaluate the oral health conditions of an institutionalized population, as well as the repercussions of the prosthesis upon dental tissues, when not dully fitted or controlled. A random selection of 372 elderly people living in Nursing Homes from the Oporto District was performed. A questionnaire was done, in order to characterize the sample in relation to some aspects, one of them being oral hygiene. The oral cavity was observed, with a consequent record of the PI (Plaque Index), the DMFT (Decayed, Missing, Filled Teeth), the RCI (Root Caries Index), the CPI (Community Periodontal Index), type of edentulism, the status of the abutment teeth and the presence of a prosthetic appliance. If one was a bearer, the prosthesis status was evaluated, and another questionnaire performed, concerning prosthetic hygiene, usage years and its manufacturer. The average age of the sample was 78.8 years (±9.1), with a DMFT of 25.6 (±7,3) and 15.1% of the elderly people having 20 or more teeth. From the 30.9% of total edentule, 5.9 were not rehabilitated. The radicular caries prevalence was of 78.6% and, as to what concerns the CPI, only 2.6% of the sextants were considered healthy, the remaining 68.8% of the sextants being excluded. In the teethed sample, 38.9% did not brush their teeth. Only 34.0% of the prosthesis abutments were healthy. The prosthesis stability, alongside with its retention, were negatively associated with full acrylic dentures. Using multivariate analysis (logistic regression), it was ascertained that those who possessed 20 or more teeth were significant and independently associated with brushing and literacy. The chance of having an RCIi of ≥ 20.0% increases 2.8 times amongst the non-brushing section and 5.3 times in the metal casted prosthesis bearers, in relation with the rest of the elders. The prosthesis hygiene was verified as being an explanatory factor for the existence of the abutment teeth lesions. In relation with this population, it is urgent the institutions implement effective preventive measures as well as a better dental follow-up, in order to decrease the need for treatment and rehabilitation. La grande hétérogénéité parmi la population âgée a causé certains doutes en ce qui concerne le concept de normalité de l’état du statut orale. Cet étude d’investigation possède l´objectif d’évaluer les conditions de la santé orale d’une population âgée institutionnalisée, ainsi que les répercussions de prosthèses dans les tissues dentaires, quand elles ne sont pas correctement adaptées ou contrôlées. Nous avons fait une sélection aléatoire de 372 personnes âgées qui vivaient dans des Maisons de Retraite, de la région du Porto. Nous avons fait un enquête pour caractériser le spécimen relativement à certains aspects, un d’entre eux étant l’hygiène orale. Nous avons fait l’observation de la cavité buccale, avec un postérieur enregistrement du IP (Indice Parodontal), du ICAO (Cariées, Absentes, Obturées), du ICR (Indice de Carie Radiculaire), du ICBTP (Indice Communautaire des Besoins en Traitements Parodontaux) le type d’édenté, le statut des dents de contrefort et la présence d’un appareil prosthétique. Si quelqu’un en possédait une, le statut de la prosthèse était évalué et un autre enquête était fait, ceci concernant l’hygiène prosthétique, les années d’utilisation et son fabricant. L´âge moyen du spécimen était de 78.8 ans (±9.1), avec un ICAO de 25.6, dans lequel 15.1% des personnes âgées possédait 20 dents ou encore plus. Des 30.9% des personnes totalement édentés, 5.9% n’était pas réhabilité. La prévalence des caries radiculaires était de 78.6% et, en ce qui concerne le ICBTP, seulement 2.6% des sextants ont été considéré sains, ce qui signifiait que les autres 68.8 % des sextants ont été exclus. Parmi le spécimen denté, 38.9% ne brossait pas leurs dents. Seulement 34.0% des contreforts prosthétiques étaient sains. La stabilité des prosthèses, ainsi que sa rétention, ont été négativement associées aux prosthèses acryliques totales. En relation aux modèles de régression logistique, nous avons vérifié que ceux qui possédait 20 dents ou encore plus devait ça, significative et absolument, au brossage et à la scolarité. La chance d’avoir un ICRi de ≥ 20.0% augmente 2.8 fois parmi le spécimen qui ne brossait pas les dents et 5.3 fois parmi ceux qu’utilisaient des prosthèses en métal, en comparaison avec les autres personnes âgées. L’hygiène de la prosthèse a été considérée comme un facteur explicatif pour l’existence de lésions dans les dents contreforts. Dans cette population, il est urgent que les Institutions installent des mesures préventives efficaces, aussi qu’un meilleur accompagnement dentaire pour minorer les nécessités de traitement et réhabilitation

Universal Adhesives and Adhesion Modes in Non-Carious Cervical Restorations: 2-Year Randomised Clinical Trial

This prospective, double-blind, six-arm parallel randomised controlled trial aimed to compare the performance of two universal adhesives (UAs) in non-carious cervical lesions (NCCLs), using the FDI criteria, and analysed if participants/NCCLs’ characteristics influenced the outcome. Thirty-eight 18- to 65-year-old participants were seeking routine dental care at a university clinic. At baseline, 210 NCCLs were randomly allocated to six groups (35 restorations’ each). The UAs tested were FuturabondU (FBU) and AdheseUniversal (ADU) applied in either etch-and-rinse (ER) and self-etch (SE) modes. FuturabondDC (FBDC) in SE and in SE with selective enamel etching (SE-EE) modes were controls. NCCLs were restored with AdmiraFusion. The analysis included nonparametric tests, Kaplan-Meier and log-rank tests (α = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p > 0.05). FBDC (p = 0.037) and FBU (p = 0.041) performed worse than ADU in SE mode. FBDC and FBU also showed worse functional success rate (p = 0.012, p = 0.007, respectively) and cumulative retention rates (p = 0.022, p = 0.012, respectively) than ADU. Some participants/NCCLs’ characteristics influenced (p < 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants’ age and NCCLs’ degree of dentin sclerosis and internal shape angle influenced FBU performance