Fernanda Cristina Pimentel Garcia

Objective: To evaluate the influence of composite resin opacity on color stability, and to analyze the performance of the ΔEab and ΔE00 formulas in detecting color changes. Material and Methods: A total of 180 specimens (n = 20 per group) were fabricated using three opacity levels (translucent/incisal, enamel, and dentin) and three commercial composite resins: Vittra APS (FGM), Harmonize (Kerr), and Herculite Précis (Kerr). Specimens (7 mm × 1 mm) were prepared using a polytetrafluoroethylene mold between glass slides and light-cured with a Bluephase N unit (650 mW/cm2 for 40 s). All specimens were stored in distilled water at 37 °C until color evaluation. Color measurements were performed using an EasyShade digital spectrophotometer at 24 hours (baseline), 30, 60, and 90 days. Color stability was assessed through color variation (ΔE) according to the CIE system, using both ΔEab and ΔE00. Data were analyzed using a three-way ANOVA (opacity, resin, and time), followed by Bonferroni post-hoc testing (α = 0.05). Results: All composite resins exhibited clinically perceptible color changes (ΔE00 > 2.25) after 90 days. Vittra APS presented the highest values at 60 and 90 days (ΔE00 = 5.09 ± 1.77 and 5.12 ± 1.62, respectively), whereas Herculite Précis showed the best overall stability, particularly for the enamel shade (ΔE00 = 3.49 ± 1.10 at 90 days); Harmonize displayed intermediate values. Dentin-shade specimens exhibited the greatest color changes (ΔE00 up to 7.59 ± 1.24). Conclusion: Color stability was influenced by the interaction among composite resin brand, opacity, and aging time. More translucent shades exhibited less color alteration over time.

Objective: This systematic review aimed to compare the clinical performance and survival rates of two restorative techniques, fragment reattachment and direct composite resin restoration, in the management of complicated crown fractures in permanent anterior teeth. Materials and Methods: A comprehensive search was conducted across seven electronic databases and the gray literature, following PRISMA guidelines. The methodological quality of the studies included was assessed using the QUIPS tool. A meta‐analysis and certainty of evidence assessment ( GRADE approach) were conducted. Results: Of the 8140 records identified, six studies met the inclusion criteria, encompassing both prospective and retrospective designs. The meta‐analysis suggested a significantly lower failure risk for composite restorations than for fragment reattachment (RR = 0.43; 95% CI: 0.24–0.79); no statistically significant heterogeneity was detected among the included studies ( I ² = 0%, p = 0.35), but only two studies were included. Fragment reattachment showed survival rates between 57.7% and 66.6%, whereas direct restorations achieved survival rates of up to 82.1%. Pulpal complications were more frequent in teeth with pulp exposure in cases treated with fragment reattachment. The certainty of the evidence was rated low for the primary outcomes. Conclusions: Within the limitations of the present study, both restorative strategies demonstrated clinical viability; however, direct composite resin restorations showed higher survival rates and lower complication risks than fragment reattachment.

Background and Aim: Reattachment of dental fragments is a conservative approach for managing enamel–dentin fractures; however, fragment dehydration may compromise esthetic outcomes. This study evaluated the influence of different dehydration periods on color differences in reattached dental fragments over 1 year. Methodology: 48 bovine incisors were sectioned to simulate enamel–dentin fractures and randomly allocated into four groups ( n = 12) according to fragment dehydration time: no dehydration, 12, 24, and 48 h. After 20 min of rehydration, fragments were reattached using a universal adhesive system and bulk‐fill resin composite. Specimens were stored in artificial saliva at 37°C. Color measurements were obtained at baseline and after 7, 14, 30, and 90 days and 1 year using the CIELAB and CIEDE2000 color systems. Data were analyzed using three‐way repeated‐measures analysis of variance followed by Bonferroni‐adjusted post hoc tests ( α = 0.05). Results: Significant three‐way interactions among dehydration time, evaluation period, and measurement location were observed for both color systems (CIELAB: F (7.17, 210.19) = 2.67, p = 0.011, ηp ² = 0.084; CIEDE2000: F (7.71, 226.28) = 2.89, p = 0.005, ηp ² = 0.090). Post hoc comparisons showed that dehydrated groups generally presented higher color differences than the control condition, particularly in the fragment region. No complete return to baseline color values was observed after 1 year. Notably, high color differences were also observed in the control group at the final evaluation. No consistent significant differences were found between the 24 and 48 h dehydration groups across most evaluation periods. Conclusions: Fragment dehydration influenced long‐term color behavior after reattachment, with clinically perceptible differences persisting over time. However, color differences were also observed in non‐dehydrated specimens, indicating that factors other than dehydration may contribute to long‐term chromatic alterations.

Objectives: To evaluate the physicochemical, optical, and antimicrobial properties of a conventional glass ionomer cement (GIC) modified with anacardic acid (LDT11). Materials and methods: LDT11, extracted from cashew nutshells, was incorporated into GIC (FX ULTRA, Shofu, USA) at 0.5%, 1%, and 2% (w/w), with 0% as control. Disc-shaped specimens (6–15 mm diameter × 1 mm thickness) were prepared for all evaluations . Setting time (ISO 9917; n = 3), acid-base reaction efficiency (FTIR, COO ⁻ /COOH ratio; n = 3), water sorption and solubility (ISO 4049; n = 5), diffusion coefficient (n = 5), surface roughness (Ra, Rz, Rv; n = 5), and color parameters (CIELab, CIEDE2000; n = 5) were measured. Antimicrobial characterizations were carried out, with discs inoculated with Streptococcus mutans UA159 and incubated anaerobically for 7 days (early biofilms) and 14 days (mature biofilms). Biofilms were dyed with the Live/Dead biofilm viability kit and then imaged using confocal laser scanning microscopy (n = 6). Data were analyzed using one-way ANOVA with Tukey post hoc or Kruskal-Wallis with Dwass-Steel-Critchlow-Fligner tests (p < 0.05). Results: LDT11 incorporation did not significantly affect setting time, acid-base reaction efficiency, solubility, diffusion coefficient, and surface roughness. FTIR spectra revealed no alterations in setting-related functional groups, while LDT11 was identified in the 1000–1100 cm⁻¹ range. At 2%, LDT11 significantly increased water sorption and caused visible color changes ( p < 0.05). The 0.5% and 1% groups significantly reduced S. mutans viability compared to control, with the 1% group exhibiting the most pronounced and sustained effect ( p < 0.0001). Conclusions: Incorporation of the anacardic acid derivative up to 1% maintained physicochemical properties of GIC while providing antimicrobial activity.

Background/Aim: This study aimed to conduct a retrospective epidemiological investigation of patients treated in an extension project at a Brazilian dental school over the past 13 years. Material and Methods: Clinical records of patients treated at a university hospital in Brazil as part of a specialized dental trauma care project were reviewed. The study included both primary and permanent teeth and covered the period from 2011 to 2024. Statistical analysis was conducted using the Pearson chi‐square, with a significance level set at 5%. Results: Of the 460 records evaluated, 375 met the inclusion criteria, encompassing a total of 833 affected teeth (220 primary and 613 permanent teeth). Males ( n = 248) represented the majority of individuals treated and exhibited a higher prevalence of hard tissue injuries ( n = 208) compared with females ( n = 93). The most common type of hard tissue injury was enamel and dentin fractures without pulp exposure ( n = 139). Patients with hard tissue injuries generally sought care promptly after the traumatic event ( p < 0.0001) and showed a significantly higher incidence of endodontic treatment needs ( p < 0.0001) than those soft tissue fractures. Falls were identified as the leading cause of all types of hard tissue fractures ( p < 0.0001). Conclusions: The study identifies a high‐risk profile for hard issue injuries, predominantly affecting children from infancy to early adolescence (ages 0–14 years), with falls being the most frequent cause. Additionally, hard tissue injuries were associated with faster care‐seeking behavior and a higher likelihood of requiring endodontic treatment.

Background/Aim: Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures.Materials and Methods: For the cross‐sectional observational study, an electronic form was designed with objective and self‐report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi‐squared or Fisher exact association tests were used in the statistical software R (version 4.2.1).Results: A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light‐cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment.Conclusion: Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure.

Aim: To determine the effects of time and temperature on the viscosity of preheated composite resins. Materials and Methods: Eleven composite resins were heated to 60°C, and temperature analyses were performed at intervals of 1 min until they had cooled to 25°C. The permanent oscillatory shear test was performed at 25°C, 35°C, 50°C, and 60°C for three composite resins under a shear rate of 1s⁻¹. One- and two-way analysis of variance were used for the analysis (α = 0.05). Results: There was no significant interaction between the composite resin and time (P = 0.9304), and only the main effect time was significantly different (P < 0.0001). A difference was observed between T0 and T6 (P < 0.001), but not after T7. The increase in temperature resulted in a viscosity reduction (P < 0.05). At 25°C, Beautifil II presented higher viscosity. Palfique LX5 showed a significant viscosity reduction with increasing temperature compared with the others (P < 0.05). For Beautifil II and Z100, there was no difference at temperatures of 50°C and 60°C, while for Palfique LX5, no statistical difference was observed at 35°C, 50°C, and 60°C. Conclusions: Ten minutes of preheating were sufficient to reach a temperature of 60°C, reducing viscosity by at least 84%. However, 5 min after removal, the composite resin cooled to room temperature. Clinical Significance: Preheating composite resin has potential benefits. To determine how this approach will work in clinical practice, it is important to define the effects of time and temperature in the protocol of this technique and understand its limitations.