Simultaneous application of conventional and experimental silanes on the adhesive strength and marginal infiltration in radicular canal with fiberglass post

Orientador: Rafael Leonardo Xediek ConsaniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo neste estudo in vitro foi avaliar o efeito da aplicação simultânea de silanos convencional e experimental na resistência adesiva e micro infiltração marginal em raízes de dentes humanos restauradas com pinos de fibra de vidro (PFV) e submetidas às ciclagens térmica e mecânica. Dois oligômeros foram sintetizados em solução com quantidades catalíticas de trietilamina. O tiol-pentaeritritol tetra-3-mercaptopropionato multifuncional (PETMP) foi combinado com isocianatos di-funcionais - 1,6-hexanodioldiissocyante (HDDI) (alifático) ou 1,3-bis (1-isocianato-1- metiletil) benzeno (BDI) (aromático). Sessenta pré-molares unirradiculares foram seccionados 2 mm acima da junção cemento-esmalte, receberam tratamento endodôntico convencional e obturação com cones de guta-percha. As raízes receberam preparo padronizado em 10 mm de profundidade com brocas de diâmetro 1,4 mm e separadas aleatoriamente em seis grupos (n=10): silanos convencionais (RelyX CP ou Angelus) e experimentais (PETMP-HDDI ou PETMP-BDI). Nos condutos foi aplicado adesivo e nos pinos silanos convencionais conforme recomendado pelos fabricantes, seguido pela aplicação de silanos experimentais. Após cimentação, as raízes receberam núcleos de preenchimento em resina composta, coroas de resina indireta e foram submetidas a 1,2 x 106 ciclos mecânicos, seguidos por 500 ciclos térmicos (5 e 55ºC). Duas fatias com 1 mm de espessura foram obtidas de cada terço radicular (cervical, médio e apical). Uma fatia de cada terço foi submetida ao teste de cisalhamento (push-out) e o padrão de fratura analisado (%) e outra fatia submetida à análise de infiltração marginal por corante (imersão em azul de metileno a 2% por sete dias) e a penetração classificada em escores (%). Fatias representativas de cada grupo foram analisadas em MEV quanto a formação de fendas marginais. Os resultados foram analisados com ANOVA dois-fatores (silano e terço), seguido pelo teste de Tukey (push-out) e teste de Kruskal-wallis (micro infiltração marginal) com nível de significância de ?=0,05. A aplicação simultânea de silanos convencional e experimental aumentou a resistência da união adesiva de PFV (p<0,001), com valores similares entre terços radiculares (p=0,199), reduziu as falhas adesivas dentina-cimento e aumentou as coesivas em dentina. Não houve diferença significante nos escores de micro infiltração por corante entre os grupos (p=0,176). Todos os grupos apresentaram micro infiltração similar ou superior a 2/3 da espessura da fatia. Em conclusão, a aplicação simultânea de silanos convencionais e experimentais proporcionou maior resistência adesiva, reduziu as falhas adesivas dentina-cimento e os níveis de micro infiltração marginal foram similares em canais radiculares tratados com PFVAbstract: The aim of this in vitro study was to evaluate the effect of simultaneous application of conventional and experimental silanes on adhesive resistance and marginal micro-infiltration in human tooth roots restored with fiberglass posts (FGP) and subjected to thermal and mechanical cycling. Two oligomers were synthesized in solution with catalytic amounts of triethylamine. Multi-functional thiol - pentaerythritol tetra-3-mercaptopropionate (PETMP) was combined with di-functional isocyanates - 1,6-hexanedioldiissocyante (HDDI) (aliphatic) or 1,3-bis (1-isocyanato-1- methylethyl) benzene (BDI) (aromatic). Sixty uniradicular premolars were sectioned 2 mm above the cemento-enamel junction, received conventional endodontic treatment and filled with gutta-percha cones. The roots received standardized preparation in 10 mm of depth with drills of diameter 1.4 mm and were randomly separated in six groups (n = 10) according to the variables: conventional silanes (RelyX CP or Angelus) and experimental silanes (PETMP-HDDI or PETMP-BDI). In the root canal, it was applied a three-step adhesive and the post silanized according to the manufacturer's recommendations, followed by the application of experimental silanes. After cementation, the roots received filling cores in composite resin, crowns of indirect resin and were submitted to 1.2 x 106 mechanical cycles, followed by 500 thermal cycles (5 and 55ºC). Two 1-mm thick slices were obtained from each root third (cervical, middle and apical). One slice of each third was submitted to the shear bond test (push-out) and the fracture pattern was analyzed (%), and other subjected to analysis of marginal infiltration by dye (immersion in 2% methylene blue for seven days) and the penetration classified into scores (%). The remaining slices of each group were analyzed in SEM for the gaps formation. The results were analyzed with two-way ANOVA (silane and third), followed by the Tukey's test (push-out) and the Kruskal-wallis' test (micro marginal infiltration) with a significance level of ?=0.05. The simultaneous application of conventional and experimental silanes on FGPs increased the bond strength (p<0.001) with similar values between root thirds (p=0.199), reduced dentin-cement adhesive failures and increased the dentin cohesive failure. There was no significant difference in the micro infiltration scores by dye between the groups (p=0.176). All groups showed micro infiltration similar to or greater than 2/3 of the slice thickness. In conclusion, the simultaneous application of conventional and experimental silanes provided greater adhesive strength, reduced the dentin-cement adhesive failures and the levels of marginal micro infiltration were similar in root canal treated with FGPsMestradoProtese DentalMestre em Clínica OdontológicaCAPE

Two-year clinical performance of cast post and core self-adhesive cementation

Introduction and Objective: Endodontically treated teeth commonly present extensive tissue loss, requiring the use intraradicular posts, which provide retention for a coronal rehabilitation. Cast post and cores (CPCs) have been traditionally used in cases of marked tooth tissue loss. Case report: This case report describes two cast post and cores and subsequent rehabilitation by metal ceramic crowns. The patient was followed-up at intervals of 12 and 24 months after the rehabilitation. The posts were cemented within the root canal with self-adhesive resin cement, in a way that guarantees a perfect sealing of the root and remains stable in the oral environment. Conclusion: Self-adhesive cements are a one-step material capable of providing additional chemical adhesion to the metal, creating a monoblock, quality not found in conventional resin cements, where the adhesion occurs only in the dentin-cement interface.Introduction and Objective: Endodontically treated teeth commonly present extensive tissue loss, requiring the use intraradicular posts, which provide retention for a coronal rehabilitation. Cast post and cores (CPCs) have been traditionally used in cases of marked tooth tissue loss. Case report: This case report describes two cast post and cores and subsequent rehabilitation by metal ceramic crowns. The patient was followed-up at intervals of 12 and 24 months after the rehabilitation. The posts were cemented within the root canal with self-adhesive resin cement, in a way that guarantees a perfect sealing of the root and remains stable in the oral environment. Conclusion: Self-adhesive cements are a one-step material capable of providing additional chemical adhesion to the metal, creating a monoblock, quality not found in conventional resin cements, where the adhesion occurs only in the dentin-cement interface

Linear dimensional stability of irreversible hydrocolloids with and without disinfection at different storage times

Irreversible hydrocolloids have been used in dental practice for decades and their pouring time has been suggested to be as short as possible; however the latest generation of alginates exhibit better properties, which could influence the fidelity of the casts. Objective: To evaluate the linear dimensional stability of stone casts obtained using two irreversible hydrocolloid brands (Cavex ColorChange and Jeltrate) after disinfection. Material and methods: Samples were divided into 16 groups (n = 10) according to brand, storage time and disinfection. Impressions were taken of a metallic master model made of stainless steel with two abutments. Cast models were obtained using type IV gypsum, after disinfection with sodium hypochlorite at 1% or without any disinfection followed by storage for four different times (immediate pouring, and after 24, 72 or 120 hours storage after obtaining the impressions) and the models were measured with a digital caliper. Data were submitted to ANOVA 3-way followed by Tukey’s test (α 0.05). Conclusion: Storage longer than 24 hours affects the fidelity of casts. Disinfection does not promote significant alteration at any of the experimental times with either material.Irreversible hydrocolloids have been used in dental practice for decades and their pouring time has been suggested to be as short as possible; however the latest generation of alginates exhibit better properties, which could influence the fidelity of the casts. Objective: To evaluate the linear dimensional stability of stone casts obtained using two irreversible hydrocolloid brands (Cavex ColorChange and Jeltrate) after disinfection. Material and methods: Samples were divided into 16 groups (n = 10) according to brand, storage time and disinfection. Impressions were taken of a metallic master model made of stainless steel with two abutments. Cast models were obtained using type IV gypsum, after disinfection with sodium hypochlorite at 1% or without any disinfection followed by storage for four different times (immediate pouring, and after 24, 72 or 120 hours storage after obtaining the impressions) and the models were measured with a digital caliper. Data were submitted to ANOVA 3-way followed by Tukey’s test (α 0.05). Conclusion: Storage longer than 24 hours affects the fidelity of casts. Disinfection does not promote significant alteration at any of the experimental times with either material

EDUCAÇÃO EM SAÚDE BUCAL A GESTANTES, PUÉRPERAS E PRIMEIRA INFÂNCIA: RELATO DE ATIVIDADE DE EXTENSÃO

A abordagem educativa durante o período gravídico-puerperal e primeira infância é fundamental para que a mãe compreenda a influência das suas ações na saúde do bebê. O projeto de extensão “Educação em saúde bucal a gestante e na primeira infância” objetiva desenvolver atividades nos âmbitos educativos e preventivos com gestantes, puérperas e primeira infância. O projeto é desenvolvido em um hospital universitário do Sul do Brasil, e conta com a participação de docentes, mestrandos, residentes em odontologia hospitalar neonatal e acadêmicos de graduação em odontologia. O projeto atua em três frentes: a primeira, com as gestantes, onde é realizada prioritariamente a abordagem educativa no pré-natal odontológico, principalmente quanto à alimentação e higiene oral adequadas; a segunda frente, no puerpério imediato, com orientações de amamentação e sucção não-nutritiva; e a terceira frente, atuando na avaliação bucal, teste da linguinha e acompanhamento do bebê até um ano de vida. Os autores constataram que o projeto auxilia na criação de um vínculo entre as gestantes/puérperas e os acadêmicos/residentes, que resulta em uma melhora na aquisição e manutenção de saúde bucal da mãe e do bebê. Assim como auxilia o desenvolvimento e capacitação dos participantes para o atendimento a este público. Palavras-chave: Assistência à Saúde, Educação em Odontologia, Gestantes, Recém-nascido, Odontopediatria, Extensão Universitária   Oral Health Education in Pregnant and Puerperal Women and Infants: Report of Extension Activity Abstract: The educational approach during the pregnancy-puerperal period and early childhood are fundamental for the mother to understand the influence of her actions on the health of the baby. The extension project "Oral health education in pregnant and early childhood” aims at developing activities in the educational and preventive areas with pregnant and puerperal women, and early childhood. The project is developed in a university hospital in southern Brazil and counts with the participation of professors, masters, residents in neonatal hospital dentistry and dental undergraduate students. The project operates on three approaches: the first, with the pregnant women, where the educational approach in dental prenatal care is carried out as a priority, especially regarding feeding and oral hygiene; the second approach, in the immediate puerperium, with guidelines for breastfeeding and non-nutritive sucking; and the third, with oral evaluation, Neonatal Tongue Screening Test and baby follow-up up to one year. The authors found that the project helps to create a bond between the pregnant/ puerperal women and the student/resident, which results in an improvement in the acquisition and maintenance of oral health of mothers and babies. It also helps the development and training of participants to attend this public. . Keywords: Health Care, Dental Education, Pregnant Women, Infant Newborn, Pediatric Dentistry, University Extension   Educación en salud bucal a gestantes, puérperas y primera infancia: relato de actividad de extensión   Resumen: El enfoque educativo durante el período gravídico-puerperal y la primera infancia son fundamentales para que la madre comprenda la influencia de sus acciones en la salud del bebé. El proyecto de extensión "Educación en salud bucal a la gestante y en la primera infancia” tiene por objeto desarrollar actividades en los ámbitos educativos, preventivos y curativos con gestantes, puérperas y primera infancia. El proyecto se desarrolla en un hospital universitario del sur de Brasil, y cuenta con la participación de docentes, residentes en odontología hospitalaria neonatal y estudiantes pregrados e postgrados de odontología. El proyecto actúa en tres frentes: la primera, con las gestantes, donde se realiza prioritariamente el abordaje educativo en el prenatal odontológico, principalmente en cuanto a la alimentación e higiene oral adecuadas; la segunda frente, en el puerperio inmediato, con orientaciones de lactancia y succión no nutritiva; y la tercera, con la evaluación bucal y del frenillo de la lengua, hasta un año de vida. Los autores constataron que el proyecto auxilia en la creación de un vínculo entre las gestantes/puérperas y los estudiantes/residentes, que resulta en una mejora en la adquisición y mantenimiento de salud bucal de la madre y del bebé. Así como auxilia el desarrollo y capacitación de los participantes para la atención a este público. Palabras-clave: Atención de Salud, Educación en Odontología, Mujeres Embarazadas, Recién Nacido, Odontología Pediátrica, Extensión Universitari

Conhecimento de gestantes sobre o teste da linguinha em neonatos

Resumo Introdução O diagnóstico e o tratamento precoce de anquiloglossia em bebês favorece o desenvolvimento adequado das funções orofaciais. O conhecimento popular sobre o teste da linguinha (TL) pode disseminar sua realização. Objetivo Verificar o conhecimento sobre o TL e sua relação com o perfil sociodemográfico de gestantes. Material e método Foram investigadas 427 gestantes que realizaram o pré-natal em um hospital escola do sul do Brasil, no período de maio a dezembro de 2017. As informações foram obtidas por meio de questionário individual contendo perguntas sobre as características sociais, demográficas e gestacionais da gestante, e o conhecimento sobre o teste da linguinha. Os dados foram analisados por estatística descritiva e as associações realizadas com o teste qui-quadrado. Resultado Os resultados demonstraram que 33 (7,7%) gestantes conhecem e 45 (10,5%) possuem informações equivocadas sobre o TL. Gestantes com grau de escolaridade (p=0,028) e renda familiar (p=0,002) maiores são mais propensas a conhecer o teste. Profissionais da enfermagem são os principais provedores da informação (64,1%). Conclusão O conhecimento de gestantes sobre o TL é superficial, especialmente entre as de menor escolaridade e renda, o que acentua a necessidade de estratégias públicas com foco em melhorar a qualidade da assistência oferecida ao binômio mãe-filho

In vitro fracture resistance and bond strength of self-adhesively luted cast metal and fiber-reinforced composite posts and cores : influence of ferrule and storage time

To evaluate the fracture resistance and bond strength of cast posts and cores (CPCs) and customized glass fiber posts (CFPs) with self-adhesive luting. A total of 56 recently extracted premolars were divided into four groups for the fracture resistance test (CPC and CFP, with and without ferrule) and four groups for the bond strength test (CPC and CFP, immediate and 6 months of storage). Differences for fracture resistance were found between CPCs and CFPs with ferrule. For bond strength, the interaction between post and root region was significant. Self-adhesive luting increased fracture resistance of CPCs with ferrule. The ferrule decreased root fractures. Bond strength was similar for both retainers but not for the apical third. Water storage affected bond strength positively32220520

Transitional Era: from analogical to digital workflow in oral rehabilitation: a case report

ABSTRACT Digital dentistry is a ubiquitous phenomenon nowadays but it requires access to technologies and learning curve. To aid digital workflow implementation, digital steps can be progressively incorporated in conventional workflows. We aimed to demonstrate a multidisciplinary oral rehabilitation performed mixing conventional procedures with digital open-source software programs and low-cost devices. A 46-year-old female patient had photographs, intraoral scans, and cone-beam computed tomography obtained and used in combination with conventional clinical exams to develop a treatment plan. Power point software was used for digital smile planing and Horos for digital implant planning. The digital dataset were used to guide conventional clinical procedures (scaling and root planning, gingivoplasty, in-office tooth bleaching, fiber-post restoration, implant and bone graft placement, teeth preparation, and protheses design and milling). The inclusion of digital steps in the conventional workflow enabled the performance of rehabilitation procedures with reduced clinical time and increased predictability, favoring the overall workflow and the communication among the different dental specialties. A mixed workflow can progressively lead to an exclusively digital workflow as technologies become accessible and learning curve is coped