Use of Glass-ionomer cement as a restorative material: a systematic review

Background: The clinical applications of glass ionomers cements (GICs) are varied: restoration, lining material, sealing, hyper sensibility care and temporary cavity restoration. Due to the lack of physical properties, over time modifications of GICs were experimented and studied by the addition of metals, fibers, ceramics to the GIC powder in the attempt to overcome these problems and improve the material and clinical performance. The aim of this study was to evaluate whether primary and permanent teeth can be definitively restored with glass ionomer cements, based on the PICO(S) question “What is the clinical performance in primary and permanent teeth restored with glass ionomer cements?”, Methods: A systematic search of the studies available in the literature was conducted in the electronic databases MEDLINE/Pubmed, Scopus and Web of Science. Two independent, calibrated examiners. The eligibility criteria were: (1) to be a systematic review (2) to evaluate the clinical longevity of GICs in primary and permanent teeth (3) to be clinical trials. The systematic reviews that met these criteria were reviewed in their entirety and those who presented at least one of the following exclusion criteria were then considered ineligible: (1) not being a systematic review of clinical trials; (2) not evaluating the longevity/clinical performance of GICs; (3) studies of dental restorative materials in teeth with enamel alterations. Results: A systematic literature search in MEDLINE/PubMed, Scopus and Web of Science databases identified 132 references potentially relevant. Twenty-four eligible articles were identified, only 13 articles were included. Methodological quality was measured using the AMSTAR-2 tool and the risk of bias of the included systematic reviews by the ROBIS tool. The level of evidence analysis was performed using the GRADE tool. Conclusions: Glass ionomer cements seems to be a viable choice in both dentitions, but primary dentition presents more evidence, especially regarding the Atraumatic Restorative Treatment (ART) technique. There is conflicting evidence on which type of glass ionomer is the best and comparisons to other dental materials are lacking. In conclusion, more high-quality studies are needed with longer follow up periods (>6 years), especially in permanent teeth.info:eu-repo/semantics/draf

Virtual reality and behaviour management in paediatric dentistry: a systematic review

Background: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. Methods: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. Results: A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. Conclusions: VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.info:eu-repo/semantics/publishedVersio

Oral health strategies: surveying the present to plan the future of community-based learning

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review’s main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy.info:eu-repo/semantics/publishedVersio

Physicochemical properties and filling capacity of an experimental iodoform-based paste in primary teeth

In this study, we evaluated the physicochemical properties (PCP; radiopacity, flow, pH, and solubility) and the quality of root canal filling provided by an experimental industrialized paste (EP), with the same active ingredients as those of the Guedes Pinto paste, compared with the Vitapex® paste. PCP were analyzed according to the ANSI/ADA laboratory testing methods for endodontic filling and sealing materials. To analyze filling capacity, 120 artificial primary teeth (60 maxillary incisors [MIs] and 60 mandibulary molars [MMs]) were endodontically treated. The teeth were divided into eight groups based on the dental group (MIs or MMs), filling material (Vitapex® or EP), and insertion method (syringe or lentulo). The Image J® software was used to analyze the initial an final digital radiographies of each tooth, measuring and comparing root canal and void areas. The percentage of filling failure areas was obtained. Data were submitted to ANOVA and Tukey test of mean comparison. Regarding PCP, both pastes presented results according the ANSI/ADA standards. Flow capacity: Vitapex: 19.6 mm, EP: 25 mm (p 0.05). Regarding filling capacity analysis, EP demonstrated 12.5% of failure against 31.5% of Vitapex (p < 0.01). Compared to Vitapex, EP presented statistically significantly better results in flow, radiopacity, pH, and filling capacity. Molars presented more filling failures than incisors. The insertion method using a syringe and a thin tip was significantly better than that using Lentulo spiral carriers.info:eu-repo/semantics/publishedVersio

Management of deep caries lesions with or without pulp involvement in primary teeth: a systematic review and network meta-analysis

There is a lack of evidence about the best approach for cavitated caries lesions with the possibility of pulpal involvement in primary teeth. Thus, the present authors aimed to verify the best treatment for deep caries lesions with or without pulp involvement in primary teeth. The search was conducted in MEDLINE/Pubmed and Web of Science databases until May 2020. Studies that compared techniques to manage deep caries lesions with at least 12 months of follow-up were included. The risk of bias was evaluated using the RoB tool. Network meta-analysis and pairwise meta-analyses were conducted considering the treatment clinical success as an outcome, according to the pulp health condition. From 491 potentially eligible studies, 9 were included. For deep caries lesions with pulp vitality, the Hall Technique presented the highest probability of success (78%). In the event of accidental pulp exposure, pulpectomy presented a 76% chance of providing the best clinical results. For pulp necrosis, no difference was observed between a pulpectomy and non-instrumented endodontic treatment (RR = 0.69; 95%CI: 0.21–2.33) Thus, it was concluded that the Hall Technique may be a better option for deep caries lesions with pulp vitality. In cases of accidental pulp exposure of vital teeth during caries removal, a pulpectomy may be considered the best option. However, there are insuficient studies to build up evidence about the best treatment option when irreversible pulpitis or pulp necrosis is present.info:eu-repo/semantics/publishedVersio

Children’s self-reported discomfort of restorative treatments for deep caries lesions in primary teeth: results from a randomized clinical trial

The aim of this study was to evaluate the impact of different restorative techniques to treat deep caries lesions of primary molars on children’s self-reported discomfort. A randomized clinical trial with two parallel arms (1:1) was conducted in São Paulo, Brazil. 4-8 years-old children with at least one occlusal or occlusoproximal deep caries lesion in primary molars were selected. Molars were randomly allocated into two groups: (1) restoration performed with calcium hydroxide cement followed by high-viscosity Glass Ionomer Cement (CHC+HVGIC), and (2) HVGIC restoration. Immediately after the intervention, children reported the experienced discomfort during restoration to an external examiner using a Wong-Baker face-scale. Children’s self-reported discomfort was analyzed using Poisson regression comparing both groups and assessing other variables’ influence (α=5%). One hundred and eight children fulfilled the eligibility criteria and were randomized in the two groups (n=54). Most of the children who received CHC+HVGIC restorations reported none or minimal discomfort (83.3%). Similar scores (92.6%) were reported for those treated with HVGIC (p=0.758). The mean reported discomfort in children with CHC+HVGIC restorations was 0.37(1.01), and 0.41(1.01) for those with HVGIC restorations. Children’s self-reported discomfort was associated with age, sex, children’s cooperation, and intervention duration. We can conclude that CHC+HVGIC or HVGIC restorations result in none or minimal discomfort in the management of deep caries lesions, being considered a reliable option

Physical stability evaluation of Guedes-Pinto paste formulations developed with different excipients

A Pasta Guedes-Pinto (GUEDES-PINTO; PAIVA; BOZZOLA, 1981), denominada neste estudo de PGP original, é utilizada há vários anos com bons resultados no tratamento endodôntico de dentes decíduos. Entretanto, a manipulação prévia e seu armazenamento para utilização posterior não tem sido viável, em virtude da deficiente estabilidade física apresentada quando os componentes são associados. Por esse motivo, os objetivos deste estudo foram: (1) Avaliar a possibilidade de preparar e armazenar a PGP; (2) Avaliar a estabilidade física de formulações selecionadas para a PGP com excipientes diferentes, armazenadas em ambiente e geladeira por até 150 dias; (3) Comparar a estabilidade física das formulações propostas para a PGP com excipientes diferentes em relação a PGP original e a Pasta de Guedes (F&A) de procedência da Farmácia Fórmula e Ação. A estabilidade física foi avaliada visualmente com o auxílio de escores, segundo os quesitos consistência, coloração e uniformidade. O estudo da estabilidade iniciou-se com a realização de pré-formulações, avaliadas por 15 dias, armazenadas em ambiente e geladeira, para o conhecimento das características físicas e prováveis dificuldades que a formulação em desenvolvimento poderia apresentar. Para seleção dos excipientes que seriam utilizados nas formulações foram realizadas diversas pré-formulações. Foram constituídas dez opções de formulações para a PGP com excipientes diferentes (denominadas A, B, C, E, F, H, I, J, L, M) tendo, como características, consistência pastosa, cor amarelo ouro e uniformidade. A estabilidade física destas foi avaliada por 150 dias, armazenadas em ambiente e geladeira. As quatro melhores formulações (B, C, H e M) foram propostas como PGP com excipientes diferentes, por obterem aos 150 dias, tanto em ambiente como em geladeira, somatória de escores 1, 1, 2 e 2, respectivamente. As PGP com excipientes diferentes foram comparadas à PGP original (em ambiente e geladeira) e a Pasta de Guedes (F&A) (em geladeira) por 150 dias. No decorrer dos 150 dias, a PGP original obteve a somatória dos escores de 7 (ambiente) e 6 (geladeira), sendo que as características físicas alteraram, principalmente, em relação à modificação da coloração e à separação de fases. A Pasta de Guedes (F&A), de maneira geral, foi à formulação que apresentou a maior somatória de escores (11) no decorrer dos 150 dias sendo, portanto, a que se comportou pior ao longo do tempo, devido à alteração da coloração e na uniformidade a partir do sétimo dia, sendo intensificadas no decorrer do tempo. Portanto, foram propostas quatro formulações da PGP com excipientes diferentes (B, C, H e M), sendo que estas apresentaram atributos mais adequados quanto aos aspectos físicos avaliados, comparativamente a PGP original e a Pasta de Guedes (F&A).Physical stability evaluation of Guedes-Pinto paste formulations developed with different excipient