Microleakage in indirect onlay restorations cemented with three different types of adhesives: an in vitro study

To evaluate the in vitro degree of marginal microleakage in indirect Class II onlay restorations cemented with dual self-adhesive, universal adhesive and dual adhesive.In the present in vitro experimental study, a total of 54 human premolar teeth were prepared and divided into three equal groups (n = 18) for placement of onlay-type restorations cemented with A: Allcem™ dual-cure adhesive cement), B: RelyX™U200 dual-cure self-adhesive cement and C: RelyX™ Ultimate universal adhesive cement. All restorations were subjected to 10,000 thermocycles between 5°C and 55°C and immersed in a 1M silver nitrate solution for 6 hours. The crowns were then sectioned mesiodistally and observed under a stereo microscope to determine the degree of marginal microleakage in the cervical area.The onlay restorations cemented with RelyX Ultimate did not present microleakage in the majority of cases (77.8%). Restorations cemented with RelyX U200 showed predominantly microleakage up to the pulp floor in 83.3% of the total, being this significantly higher microleakage than in restorations cemented with RelyX Ultimate and Allcem Dual (p<0.001 and p<0.001 respectively). There was no significant difference in microleakage between the last two mentioned cements (p=0.255) Allcem dual adhesive cement and RelyX Ultimate universal adhesive showed significantly less microleakage than RelyX U200 dual-curing self-adhesive cement at the cervical level, with predominantly no microleakage and microleakage down to the enamel, respectively. The use of RelyX Ultimate cement in indirect restorations is recommended as it showed better marginal adaptation

Effect of Additional Dry Heat Curing on Microflexural Strength in Three Types of Resin Composite: An In Vitro Study

Aim: Additional dry heat curing is a method that favorably influences the mechanical properties of an indirect resin composite restoration. Microflexural strength is a property currently applied for the evaluation of indirect resin composite restorations. The aim of the present study was to assess the effect of additional dry heat curing on microflexural strength in three types of direct-use resin composites. Materials and Methods: This in vitro study consisted of 70 resin composites samples made with a 6 × 2 × 1 mm metal matrix and divided into seven experimental groups, which included Gr1a: Tetric N-Ceram without additional dry heat curing (n = 10); Gr1b: Tetric N-Ceram with additional dry heat curing (n = 10); Gr 2a: Filtek Z350 XT without additional dry heat curing (n = 10); Gr2b: Filtek Z350 XT with additional dry heat curing (n = 10); Gr3a: Filtek Z250 without additional dry heat curing (n = 10); Gr3b: Filtek Z250 with additional dry heat curing (n = 10); and Gr4: SR Nexco Paste (control) without additional dry heat curing (n = 10). The samples were stored in distilled water at 37 °C for 24 h. A universal testing machine with a 2000 N load cell at a speed of 1 mm/min was used to assess flexural strength. The data were analyzed with a parametric ANOVA test with Tukey’s post hoc intergroup factor (for groups without heat treatment) and a nonparametric Kruskall Wallis test with Bonferroni’s post hoc (for groups with heat treatment). In addition, the comparison of independent groups in each resin composite type with and without heat treatment was performed with a Mann Whitney U test. A significance level of p < 0.05 was considered. Results: The Filtek Z250 resin composite with and without additional dry heat curing presented the highest microflexural strength values with 137.27 ± 24.43 MPa and 121.32 ± 9.74 MPa, respectively, while the SR Nexco Paste (control) resin composite presented the lowest microflexural strength values with 86.06 ± 14.34 MPa compared to all the resin composites with additional dry heat curing. The Filtek Z250 and Filtek Z350XT resin composites with and without additional dry heat curing presented significantly higher microflexural strength versus the SR Nexco (p < 0.05) and Tetric N-Ceram (p < 0.05) resin composites. In addition, the Filtek Z350XT and Tetric N-Ceram resin composites with additional dry heat curing showed significantly higher microflexural strength (p < 0.05) compared to those without additional dry heat curing. Conclusions: The Filtek Z250 and Z350XT resin composites had significantly higher microflexural strength values with and without additional dry heat curing. In addition, the Filtek Z350XT and Tetric N-Ceram resin composites subjected to additional dry heat curing showed significantly higher microflexural strength compared to when they did not receive the same procedure, a situation that did not occur with the Filtek Z250 resin composite.Revisión por pare

"In Vitro Color Stability Evaluation of Three Polished and Unpolished Nanohybrid Resin Composites Immersed in a 0.12% Chlorhexidine-Based Mouthwash at Different Times"

"The use of chlorhexidine-based mouthwashes on resin composites with rough surfaces can cause discoloration which compromises the esthetic of patients. The present study aimed to evaluate the in vitro color stability of Forma (Ultradent Products, Inc., South Jordan), Tetric N-Ceram (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z350XT (3M, ESPE, St. Paul, MN, USA) resin composites, with and without polishing, after being immersed in a 0.12% chlorhexidine (CHX)-based mouthwash at different times. The present in vitro experimental and longitudinal study used 96 nanohybrid resin composite blocks (Forma, Tetric N-Ceram and Filtek Z350XT) 8 mm in diameter and 2 mm thick, evenly distributed. Each resin composite group was divided into two subgroups (n = 16) with and without polishing and then immersed in a 0.12% CHX-based mouthwash for 7, 14, 21 and 28 days. Color measurements were performed with a calibrated digital spectrophotometer. Nonparametric tests were used to compare independent (Mann–Whitney U and Kruskal–Wallis) and related (Friedman) measures. In addition, the Bonferroni post hoc correction was used considering a significance level of p < 0.05. All polished and unpolished resin composites presented color variation < 3.3 when immersed for up to 14 days in 0.12% CHX-based mouthwash. The polished resin composite with the lowest color variation (∆E) values over time was Forma, and the one with the highest values was Tetric N-Ceram. When comparing the color variation (∆E) over time, it was observed that the three resin composites, with and without polishing, presented a significant change (p < 0.001), although these changes in color variation (∆E) were evident from 14 days between each color acquisition (p < 0.05). The unpolished Forma and Filtek Z350XT resin composites showed significantly more color variation than the same polished ones at all times when immersed in a 0.12% CHX-based mouthwash for 30 s daily. In addition, every 14 days, all three resin composites with and without polishing showed a significant color change, while, every 7 days, color stability was maintained. All the resin composites showed clinically acceptable color stability when exposed for up to 14 days to the above-mentioned mouthwash.

COVID 19 y Odontología: Medidas preventivas en el desarrollo de la práctica odontológica

COVID-19 in Dentistry is a public health priority for which a series of drastic preventive measures have been applied to help prevent community contagion of the virus, the objective of this study is to describe preventive measures against Covid-19 in the development of dental practice. That is why the importance of the use of all protection barriers such as the use of personal protective equipment (PPE) for dentists, hand washing, screening, triage of patients, cleaning and disinfection of surfaces, preparation of the clinical field, protocol prior to care, provisions for the management of stomatological procedures, use of antiseptic rinses prior to the procedure, placement of a rubber dam, use of high-powered evacuation suctors, disinfection at the end of treatment and dental waste management. It is concluded that it is necessary to use preventive biosafety measures through the correct execution of standards such as hand washing protocol, the use of a disinfectant such as 70% alcohol and the use of a filtering respirator such as N95; in addition to the use of an antiseptic rinse prior to the procedure, the placement of a rubber dam, and the use of a high-powered evacuation suction device.El objetivo del estudio fue describir las medidas de prevención y control de la COVID-19 en el desarrollo de la práctica odontológica. El COVID-19 es una enfermedad causada por el virus SARSCoV- 2 que ha afectado a gran parte de la población mundial por su naturaleza altamente infecciosa. La actividad más vulnerable de contaminación cruzada y difusión de esta enfermedad es la práctica Odontológica, debido al contacto directo con los aerosoles y la exposición directa a la cavidad oral. Por ello es necesario aplicar una serie de medidas preventivas drásticas que ayuden a prevenir el contagio comunitario del virus. Es por ello que todo paciente que acude a la consulta odontológica debe ser tratado como paciente de riesgo y potencialmente sospechoso para COVID-19, por ello antes, durante y después de la atención odontológica se debe aplicar protocolo de atención con el fin de proteger al paciente y al personal odontológico

La nueva pandemia por SARS-CoV-2: epidemiología y la respuesta del sistema de salud peruano

The World Health Organization declared the new disease (COVID-19) a pandemic on March 12, and as of January 13, 2021, there were more than 86 million confirmed cases of COVID-19 have been recorded worldwide. In the world, at the Latin American level, Peru ranks fifth with 1,082,907 confirmed cases, presenting a fatality rate of 3.63%. In the same way, the Peruvian State, in response to this COVID-19 disease, issued a regulation through the Ministry of Health (MINSA) in order to counteract the contagion and number of deaths. Although Peru was one of the first countries in the region to implement restrictive measures in the first months, it was one of the most affected; together with the guidelines implemented by MINSA institutions, they did not reflect the expected results, observing the availability of 141 beds of Intensive Care Unit (ICU) nationwide as of January 21, 2021 and Peru in fifth place in the number of infections in Latin America with 1,082,907 confirmed cases and 39,274 deaths with a fatality rate of 3.63%.Desde que la Organización Mundial de la Salud declaró el 12 de marzo a la nueva  enfermedad COVID-19 como pandemia, hasta la fecha  13 de enero de 2021 se han registrado más de 86 millones de casos confirmados de COVID-19 en todo el mundo, a nivel de Latinoamérica, Perú se encuentra en el quinto lugar con 1 082 907 casos confirmados presentando una tasa de letalidad de 3,63%. Así mismo el estado peruano en respuesta a esta enfermedad por COVID-19, emitió normativas a través del Ministerio de Salud (MINSA) con la finalidad de contrarrestar el contagio y cantidad de defunciones. A pesar de haber sido Perú uno de los primeros países en la región en ejecutar medidas restrictivas en los primeros meses del 2020, que junto a las directrices ejecutadas por las instituciones del MINSA, no reflejaron los resultados esperados, observándose al 21 de enero de 2021 la disponibilidad de 141 camas en la Unidad de Cuidados Intensivos (UCI) a nivel nacional, y a Perú en el quinto lugar en cifras de contagios en Latinoamérica con 1 082 907 casos confirmados, y 39 274 fallecidos

COVID-19 y su impacto en la odontología

COVID-19 is a recent disease, this virus has shown in various studies to have an approximate incubation time of five days. The health areas, including the area of dentistry, have been seen in a panorama of high vulnerability and exposure, this has allowed modifying the role of the dental surgeon during this pandemic, adopting new biosafety guidelines to keep the health of healthcare personnel and patients. Thus, the protocols for the use of PPE, oral cavity antisepsis and disinfection have become pillars of emergency and emergency treatment care. The objective of this literature review is to highlight the information collected during the health crisis and the updating of protocols adopted by dental surgeons and healthcare personnel to provide adequate care during the pandemic.El COVID-19 es una nueva enfermedad, este virus ha demostrado en diversos estudios tener un tiempo de incubación aproximado de cinco días. Las áreas sanitarias, incluyendo el área odontológica, se han visto en un panorama de alta vulnerabilidad y exposición, ello ha permitido modificar el rol del cirujano dentista durante esta pandemia, adoptando nuevos lineamientos de bioseguridad para preservar la salud del personal asistencial y pacientes. Es así que los protocolos en el uso de EPP, antisepsia de la cavidad bucal y desinfección se han convertido en pilares de la atención de tratamientos de urgencia y emergencia. El objetivo de la presente revisión de literatura es evidenciar la información recolectada durante la crisis sanitaria y la actualización de protocolos adoptados por los cirujanos dentistas y personal asistencial para dar una atención adecuada durante la pandemia

La salud bucal en América Latina: Una revisión desde las políticas públicas

Introduction: In many countries, oral health is not a priority health issue, which constitutes a fundamental challenge for health systems, which must guarantee universal and equitable access to basic oral health services for all and without economic difficulties. Aim: The purpose of the article was to carry out an analysis of public policies in oral health adopted in Latin America. Methodology: The methodology responds to a narrative review, resorting to various bibliographic sources, through databases such as Pubmed, Scopus, Web of Science, SciELO and Redalyc. Results: The results indicate that most oral health policies in Latin America are focused on clinical, individualized, curative and restorative care, where health promotion and community participation continue to be the fundamental strategies to overcome deep inequalities. in health facing Latin Americans. Conclusions: It is concluded that it is essential to carry out oral health epidemiological studies in Latin America since they are part of essential tools for decision making, development, implementation and execution of policies, plans and strategies based on scientific evidence, as well as the approach multisectoral analysis of the social determinants of health.Introducción: En muchos países la salud bucodental no es un tema prioritario en salud, lo cual constituye un desafío fundamental para los sistemas de salud, los cuales deben garantizar el acceso universal y equitativo a los servicios básicos de salud bucal para todos y sin dificultades económicas. Objetivo. El propósito del artículo fue realizar un análisis de las políticas públicas en la salud bucal adoptadas en América Latina. Metodología: La metodología responde a una revisión narrativa, recurriéndose a diversas fuentes bibliográficas, a través de bases de datos como Pubmed, Scopus, Web of Sciencie, SciELO y Redalyc.Resultados: Los resultados indican que la mayor parte de las políticas en salud bucal en América Latina están centradas en la atención clínica, individualizada, curativa y restaurativa, en donde la promoción de la salud y la participación comunitaria continúan siendo las estrategias fundamentales para superar las profundas desigualdades en salud que enfrenta los latinoamericanos. Conclusiones: Se concluye que es fundamental realizar estudios epidemiológicos en salud bucal en América Latina ya que forman parte de herramientas esenciales para la toma de decisiones, el desarrollo, la implementación y la ejecución de políticas, planes y estrategias basadas en la evidencia científica, así como el abordaje multisectorial de los determinantes sociales de la salud

Sociodemographic factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students: a cross-sectional study under a multivariable analysis

Background: Epilepsy is a chronic neurological disease that could indirectly affect oral health, and it is necessary for dentists to be familiar with the specific needs of patients with epilepsy. Therefore, aim of the present study was to assess the factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students. Methods: This analytical, observational, cross-sectional and prospective study assessed 312 dental students from a Peruvian university during February to April 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of knowledge about dental management in epileptic patients. A logit model was used to assess the influence of variables: gender, age, year of study, marital status, place of origin and area of residence, with the level of knowledge in dental students considering a significance level of p 0.05). Conclusion: Most of the students showed a poor and fair level of knowledge about the dental management of epileptic patients, with gender, academic year and place of origin being influential factors. It is advisable that authorities and teachers in the dental profession organize recurrent training programs on the care of patients with chronic diseases requiring special attention, since knowing general concepts, pharmacological management and dental care of epileptic patients will allow future dentists to develop competencies to improve and implement good quality care protocols for this group of patients.Revisión por pare

Evaluación antibacteriana del peróxido de hidrógeno comparado con hipoclorito de sodio sobre cepillos dentales inoculados con Streptococcus mutans

Objective: To assess the antibacterial effect of 6% hydrogen peroxide (H2O2) compared with 1% and 2% sodium hypochlorite, on toothbrushes inoculated with Streptococcus mutans ATCC® 25175™. Materials and methods: The study design was an experimental in vitro, cross-sectional prospective and comparative study. Sixty toothbrushes were used, which were divided into four groups of 15 brushes. After conducting a pilot study, the sample number was determined by the means comparison formula and these were selected by simple random sampling. These brushes were inoculated with strains of S. mutans ATCC® 25175™. The disinfectants included H2O2 at 6% and sodium hypochlorite (NaOCl) at 1% and 2%. The Shapiro–Wilk test was used to assess normality and the Mann-Whitney U test was applied for the hypothesis test. Results: The 6% H2O2 showed an average growth of 2 × 109 CFU/mL, which indicates that its effectiveness is greater compared to the 1% NaClO that showed a growth average of 4 × 109 CFU/mL which is less than the 2% NaClO that presented 0 CFU/mL of S. mutans (p = 0.004). Conclusion: Between 6% H2O2 and 1% and 2% NaClO, specifically antibacterial detection, 2% NaClO was concluded as being the most effective.Objetivo: avaliar o efeito antibacteriano do peróxido de hidrogênio 6% em comparação ao hipoclorito de sódio 1% e 2%, em escovas de dente inoculadas com Streptococcus mutans ATCC® 25175™. Materiais e métodos: estudo experimental in vitro, transversal e comparativo. Foram utilizadas 60 escovas de dente, as quais foram divididas em 4 grupos de 15 escovas cada um. O número amostral foi determinado pela fórmula de comparação de médias, após realização de um estudo piloto, sendo selecionado por meio de amostragem aleatória simples. As escovas foram inoculadas com cepas de Streptococcus mutans ATCC® 25175™. Os desinfetantes utilizados foram peróxido de hidrogênio (H202) 6% em comparação ao hipoclorito de sódio (NaClO) 1% e 2%. Aplicou-se a prova de normalidade de Shapiro-Wilk e como teste de hipótese utilizou-se o U de Mann-Whitney. Resultados: o H202 6% apresentou uma média de crescimento de 2.109 UFC/mL, indicando uma efetividade maior em comparação com o NaClO 1% que apresentou uma média de crescimento de 4.109 UFC/mL, que por sua vez foi menos efetivo que o NaClO 2% que apresentou uma contagem de 0 UFC/mL de Streptococcus mutans (p=0,004). Conclusão: o H2O2 6% e o NaClO 1% e 2%, apresentaram efetividade antibacteriana, sendo que o NaClO 2% foi totalmente efetivo.Objetivo: evaluar el efecto antibacteriano del peróxido de hidrógeno (H2O2) al 6 % comparado con hipoclorito de sodio (NaClO) al 1 % y al 2 %, sobre cepillos dentales inoculados con Streptococcus mutans atcc® 25175™. Materiales y métodos: estudio experimental in vitro, transversal y comparativo. Se utilizaron 60 cepillos dentales, divididos en 4 grupos de 15 cepillos cada uno. El número de muestra lo determinó la fórmula de comparación de medias, después de realizar un estudio piloto, y se seleccionaron por muestreo aleatorio simple. Se aplicaron las pruebas de normalidad de Shapiro-Wilk, y para la prueba de hipótesis, la U de Mann-Whitney. Resultados: el H2O2 al 6 % presentó una media de crecimiento de 2 × 109 UFC/mL, lo que indica que su efectividad es mayor comparada con el NaClO al 1 %, que presentó una media de crecimiento de 4 × 109 UFC/mL, y esta es menor al NaClO al 2 %, que tuvo 0 UFC/mL de Streptococcus mutans (p = 0,004). Conclusión: el H2O2 al 6 % y el NaClO al 1 % y al 2 % evidenciaron efectividad antibacteriana, aun cuando fue el NaClO al 2 % el más efectivo

Factors Associated with Epidemiological, Preventive and Health Care Knowledge of Dentists from North of the Peruvian Capital about COVID-19: A Cross-Sectional Study under a Predictive Model

Aim: In dental practice there is a high risk of contact with fluids that may contain SARS-CoV-2. Salivary secretions in the form of droplets are the main route of infection. The present study aimed to evaluate factors associated with epidemiological, preventive and health care knowledge of dentists from the north of the Peruvian capital about COVID-19. Materials and Methods: This analytical, observational, cross-sectional and prospective study evaluated 142 dental professionals from the Directorate of Integrated Health Networks (DIRIS) in the north of the Peruvian capital during June to August 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of epidemiological, preventive and health care knowledge about COVID-19. A logit model was used to evaluate the influence of the following variables: age, sex, marital status, children, origin, university of origin, academic degree, work modality, work status and number of training courses. In addition, a predictive model was constructed with the causal variables considering a significance level of p < 0.05. Results: Epidemiological, preventive and health care knowledge about COVID-19 was fair in 17.6%, 34.5% and 57.7%, respectively. Likewise, all the variables analyzed were influential factors. It was observed that being single (OR = 0.05, CI: 0.01–0.26), having studied at a private university (OR = 0.09, CI: 0.023–0.38) and having received four to six trainings on COVID-19 related topics (OR = 0.02, CI: 0.002–0.238) were protective factors against fair knowledge. Conclusions: More than half of the dentists surveyed had fair knowledge about COVID-19. The factors that favored a good level of overall knowledge were: being single, having studied at a private university and having received 4 to 6 training courses on COVID-19-related topics. It is advisable that the competent authorities continue to educate dental professionals with training programs about infection control practices in accordance with the health care work they perform in their specialty. It will also be of utmost importance for the professional to be updated with reliable information accredited by the Centers for Disease Control and Prevention as well as the WHO