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

COVID-19 management in clinical dental care part III: patients and the dental office

The coronavirus 2019 (COVID-19) pandemic dramatically changed all aspects of life. In the context of clinical dental care, a significant number of new recommendations have been implemented to comply with public health policies, ensuring the safety of dental care professionals, staff, and patients and preventing further spread of the virus. This article is the third in a series of 3 on the management of COVID-19 in clinical dental care and presents a set of recommendations and standards to be implemented in the context of the COVID-19 pandemic. These include remote contact with all patients for triage and guidance before scheduling a clinical visit to know if they have COVID symptoms or are positive for COVID, if they belong to a risk group, and if there is a suggestion that aerosol-generating procedures (AGPs) will be required during their visit. It also reviews additional precautionary measures in the waiting room and reception area, where the environment is reorganised to protect patients and clinical staff, avoiding situations that could result in cross contamination. The dental office operates under a strict set of guidelines, namely, use of personal protective equipment by professionals, contact with patients, a strategy to avoid aerosol-generating procedures, as well as disinfection procedures for the dental office before, during, and after each patient visit. The implementation of these protocols to mitigate cross infection and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the dental office will help improve safety and restore the confidence required to provide dental care to patients during the COVID-19 pandemic.info:eu-repo/semantics/publishedVersio

High-power LED units currently available for dental resin-based materials—A review

The pursuit of less time-consuming procedures led to the development of high-power light-curing-units (LCU) to light-cure dental-resin-based-materials. This review aims to describe high-power light-emitting-diode (LED)-LCUs, by a bibliometric systematization of in vitro and in vivo studies. The research-question, by PICO model, aimed to assess the current knowledge on dentistry-based high-power LED-LCUs by analyzing to what extent their use can promote adverse events on materials and patients’ oral condition when compared to low-power LED-LCUs, on daily dental practice. PubMed and B-on database search focused on high-power (≥2000 mW/cm2 ) LED-LCUs outputs. Studies assessing performance of high-power LED-LCUs for light-curing dental-resin-based-materials were included. From 1822 screened articles, 21 fulfilled the inclusion criteria. Thirty-two marketed units with high levels of radiant emittance (≥2000 mW/cm2 up to 6000 mW/cm2 ) were identified. Most output values vary on 2000–3000 mW/cm2 . The highest output found was 6000 mW/cm2 , in FlashMax™P3. Reports suggest that light-curing protocols with lower emittance irradiance and longer exposure outperforms all other combination, however in some clinical procedures high-power LED-LCUs are advocated when compared to low-power LED-LCUs. Moreover, long time exposures and over-curing can be dangerous to the biological vital pulp, and other oral tissues. Evidence showing that high-power LCUs are the best clinical option is still very scarce

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&rsquo; 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&rsquo; 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 (&alpha; = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p &gt; 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&rsquo; characteristics influenced (p &lt; 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants&rsquo; age and NCCLs&rsquo; degree of dentin sclerosis and internal shape angle influenced FBU performance

Restaurações de fracturas coronárias de dentes anteriores

Nowadays crown fractures of anterior teeth are getting more common in children and teenagers. These kinds of accidents can affect them for the rest of them lives, behalf of their age, gender or socioeconomic status. This is one of the reasons why dentists are always trying to find different solutions for the treatment of these cases. Mainly in anterior teeth fractures involving enamel or enamel and dentin, one has the direct restoration solution, using composite resin. In this case, the introduction of the “self-etch” technique, and the evolution of adhesive systems and the better physical and aesthetic behaviour of the composite resins, lead to better results. Thus, one can consider the direct restoration as a valid solution that can be done quickly and still is aesthetic and as an excellent clinical behaviour. The authors present a clinical case of an extended traumatic fracture treated with a micro-hibrid composite resin.As fracturas coronárias de dentes anteriores por traumatismo são cada vez mais frequentes em crianças e jovens, marcando, muitas vezes, as pessoas de forma indelével para o resto da vida, independentemente da idade, do sexo e do nível sócio-económico do paciente. Por esse motivo, a restauração adequada destes dentes tem sido uma preocupação constante dos médicos dentistas, existindo neste momento várias soluções disponíveis. Principalmente nas fracturas coronárias de dentes anteriores em que está envolvido apenas o esmalte ou o esmalte e a dentina, uma das várias hipóteses de tratamento é a sua reconstrução directa, através do uso de resinas compostas. O advento da técnica do condicionamento ácido do esmalte e dentina, em conjunto com a evolução dos sistemas adesivos e do comportamento físico e estético dos compósitos, ampliou as possibilidades de tratamento restaurador para estes casos. Assim, a reconstrução directa transformou-se numa opção válida e fiável em que são realizados procedimentos simples, rápidos, seguros e esteticamente agradáveis. Dentro deste âmbito, descreve-se um caso clínico, onde se realizou uma reconstrução directa com um compósito micro-híbrido, com o auxílio de uma coroa de acetato, de uma fractura coronária extensa de um dente anterior provocado por traumatismo.info:eu-repo/semantics/publishedVersio

Técnica para obtenção do ponto de contacto em restaurações de classe II com compósito

A criação de um bom ponto de contacto em classes II com compósito, implica a escolha clínica do sistema matriz / cunha mais eficaz para cada caso. Para as situações em que a quantidade de estrutura remanescente está diminuída, os autores desenvolveram uma técnica que facilita a inserção e fixação da matriz para realizar o contorno proximal da restauração. São utilizados os compósitos microhíbridos em conjunto com os condensáveis, para maximizar as propriedades ideais de cada um e assim obter um melhor ponto de contacto

Técnica para obtenção do ponto de contacto em restaurações de classe II com compósito

A criação de um bom ponto de contacto em classes II com compósito, implica a escolha clínica do sistema matriz / cunha mais eficaz para cada caso. Para as situações em que a quantidade de estrutura remanescente está diminuída, os autores desenvolveram uma técnica que facilita a inserção e fixação da matriz para realizar o contorno proximal da restauração. São utilizados os compósitos microhíbridos em conjunto com os condensáveis, para maximizar as propriedades ideais de cada um e assim obter um melhor ponto de contacto

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