Clinical management for epidermolysis bullosa dystrophica

Epidermolysis bullosa (EB) consists of a group of genetic hereditary disorders in which patients frequently present fragile skin and mucosa that form blisters following minor trauma. More than 20 subtypes of EB have been recognized in the literature. Specific genetic mutations are well characterized for most the different EB subtypes and variants. The most common oral manifestations of EB are painful blisters affecting all the oral surfaces. Dental treatment for patients with EB consists of palliative therapy for its oral manifestations along with typical restorative and periodontal procedures. The aim of this article is to describe two dental clinical treatments of recessive dystrophic EB cases and their specific clinical manifestations. The psychological intervention required during the dental treatment of these patients is also presented

Dentina bovina: Substrato viável para adesão?

Dentina bovina: Substrato viável para adesão

The Perception of Smile Attractiveness Variations from Esthetic Norms, Photographic Framing and Order of Presentation

Objectives: To evaluate the attractiveness of a smile according to variations from esthetic norms, photographic framing, and the order of the presentation of photographs.Materials and Methods: A photograph of an individual was selected and digitally manipulated to create the following smiles: an ideal control smile (I), a smile with diastema (D1), a smile with midline deviation (LM3), a smile with deviation from the long axes of the lateral incisors (10D), and a smile with an inverted smile arc (LSRV). The manipulated photographs were developed in framings of the face and of the mouth and evaluated by 20 laypeople. For half the evaluators, the presentation started with facial photographs and, for the other half, the presentation began with the mouth shots. Evaluators were asked to rank the photographs from the least to the most attractive; then, each photograph was awarded a mark (scale of 0.0 to 10.0).Results: In both presentations, the smiles I, LM3, 10D, and LSRV received favorable ratings, whereas the D1 smile got poor ratings. The photographic framings used (face vs mouth) and the order of presentation of the photographs did not influence the rankings.Conclusion: The absence of variations from beauty norms of a smile has a positive impact on its esthetic perception, but variations from the norms do not necessarily result in reduced attractiveness. (Angle Orthod. 2009;79:634-639.

The influence of time interval between bleaching and enamel bonding

Objectives: the purpose of this study was to investigate the penetration of a conventional adhesive material into enamel bleached with 16% carbamide peroxide and 38% hydrogen peroxide using optical light microscopy.Methods: Extracted human teeth were randomly divided into eight experimental groups with six specimens each, according to the bleaching material and time interval after bleaching and before the bonding procedure. Groups were designated as follows: control group, restorations in unbleached teeth; restorations performed immediately after bleaching; restorations performed 7 days after bleaching; restorations performed 14 days after bleaching; and restorations performed 30 days after bleaching. The length of resin tags was measured with an Axiophot photomicroscope at 400x magnification for the calculation of the proportion of tags of study groups compared to the respective control groups. Analysis of variance was applied for comparison between groups; data were transformed into arcsine (p < 0.05).Results: the specimens of experimental groups, in which restorations were performed 7, 14, and 30 days after bleaching, showed better penetration of adhesive material into enamel than specimens restored immediately after bleaching. There was no statistically significant difference between the bleaching materials employed or in the interaction between bleaching agent and time interval.Conclusions: This suggests that a time interval of at least 7 days should be allowed between enamel bleaching and placement of adhesive bonding agents for accomplishment of composite resin restorations

Efeito de fontes de luz na microdureza de resinas compostas

This study assessed the surface microhardness of compound resins cured by different light sources. Methods Three micro hybrid (Vit-l-escence, Amelogen Plus, Opallis) and one nanoparticle (Filtek Z350, 3M ESPETM Dental Products, St. Paul, USA) compound resins were selected. The resins were polymerized by a halogen light unit (Ultralux, Dabi Atlante, Ribeirão Preto, Brasil) with two tips, one semi-guided made of glass and another of painted acrylic and a LED-based source (UltraLume 2, Ultradent®, South Jordan, USA). Specimens constructed from a circular aluminum matrix were photopolymerized for 40 second after they received the compound resin and stored dry for 24 hours. After this period, a Vickers surface microhardness assay was performed, measuring the top (hardness 1) and base (hardness 2) surfaces four times each. Variance analyses were complemented by Newman-Keuls method, with significance set at 5%. Results The Opallis (FGM, Santa Catarina, Brasil) resin subjected to UltraLume 2 (Ultradent®, South Jordan, USA) obtained the lowest mean hardness values for the top surface. The Vit-l-escence (Ultradent®, South Jordan, USA) compound cured by Led UltraLume 2 (Ultradent®, South Jordan, USA) and by Ultralux PCP (Dabi Atlante, Ribeirão Preto, Brasil) halogen light obtained the highest mean hardness, followed by the Filtek Z350 (3M ESPETM Dental Products, St. Paul, USA) resin subjected to UltraLume 2 (Ultradent® South Jordan, USA). The Opallis (FGM, Santa Catarina, Brasil) resin cured by LED UltraLume 2 (Ultradent®, South Jordan, USA) also obtained the lowest mean hardness for the base surface and the Vit-L-Escence (Ultradent®, South Jordan, USA) resin obtained the highest value, followed by Amelogen Plus, when cured by Ultralux (Dabi Atlante, Ribeirão Preto, Brasil) using the semi-guided tip. Conclusion The polymerization and, consequently, the microhardness achieved by the LED unit was equivalent to those achieved by conventional halogen units for three of the four composites tested.Avaliar a microdureza superficial de resinas compostas polimerizadas por diferentes fontes de luz. Métodos Foram selecionadas três resinas compostas microhíbridas (Vit-l-escence, Amelogen Plus, Opallis) e uma nanoparticulada (Filtek Z350, 3M ESPETM Dental Products, St. Paul, USA). Foram submetidas à polimerização utilizando-se um aparelho halógeno (Ultralux, Dabi Atlante, Ribeirão Preto, Brasil) com duas ponteiras, uma de vidro semi-orientada e outra de acrílico pintada e também um dispositivo à base de LED (UltraLume 2, Ultradent®, South Jordan, USA). Os corpos-de-prova obtidos a partir de uma matriz circular de alumínio, após receberem a resina composta, foram fotopolimerizados por 40 segundos e em seguida armazenados a seco por 24 horas. Decorrido esse período, procedeu-se ao ensaio de microdureza superficial Vickers, realizando-se quatro aferições na superfície de topo (dureza 1) e na superfície de base (dureza 2). Utilizou-se a análise de variância que foi complementada pelo teste de Newman-Keuls de comparações múltiplas de médias, ao nível de significância de 5%. Resultados No topo, as menores médias de dureza foram obtidas com a resina Opallis submetida ao UltraLume 2 (Ultradent®, South Jordan, USA). As médias maiores referem-se ao compósito Vit-l-escence (Ultradent®, South Jordan, USA) polimerizado com o Led UltraLume 2 (Ultradent®, South Jordan, USA) e luz halógena Ultralux PCP (Dabi Atlante, Ribeirão Preto, Brasil), seguidas da resina Filtek Z350 (3M ESPETM Dental Products, St. Paul, USA) submetida ao UltraLume 2 (Ultradent®, South Jordan, USA). Quanto à base, a menor média de dureza também foi da resina composta Opallis (FGM, Santa Catarina, Brasil), sob ação do LED UltraLume 2 (Ultradent®, South Jordan, USA) e a maior da Vit-l-escence (Ultradent®, South Jordan, USA), seguida pela Amelogen Plus (Ultradent®, South Jordan, USA) quando polimerizada pelo Ultralux (Dabi Atlante, Ribeirão Preto, Brasil) com a ponta semi-orientada. Conclusão O aparelho LED permitiu polimerização e consequentes valores de microdureza equivalentes ao dos aparelhos halógenos convencionais, para três dos quatro compósitos avaliados

Avaliação da influencia do tratamento superficial na resistência de união dos reparos com resina composta em cerâmica.

Avaliação da influencia do tratamento superficial na resistência de união dos reparos com resina composta em cerâmica

Analysis of the efficiency of different materials used as cervical barrier in endogenous bleaching

Objective: Evaluate the efficiency of three materials used for making the cervical buffer on the bleaching procedure. Methods: Thirty-six, recently extracted human canines were used, and divided into four experimental groups of nine replicas in each group. Group I was the control group, in which no sealing was done in the cervical region; Group II corresponded to the cervical buffer made by chemically activated glass ionomer cement (Vidrion R); in Group III resin-modified glass ionomer cement (Vitremer, 3M, Sumaré, Brazil) was used as the cervical buffer; and in Group IV Coltosol temporary restorative cement was used. A paste of sodium perborateand 30% hydrogen peroxide was placed in the pulp chamber for seven days, followed by placement of a dye to evaluate microleakageafterwards. Results: The results obtained among the experimental groups were statistically significant. Conclusion: That Coltosol was the most effective material against leakage in the apical direction. Vitremer (3M, Sumaré, Brazil) occupied the intermediate position among the groups, and Vidrion behave better than the control group only, therefore, with precarious sealing properties