Rafael Santos Rocha

Objective: To evaluate the possible clinical association between dental fracture and the presence of amalgam restorations, including other restorative treatments in the control group. The potential association of fractures with dental wear facets and the restoration size was also assessed as a secondary objective.

A systematic review and network meta‐analysis was performed to provide evidence for the best polishing protocol for different types of resin composites to minimize surface roughness. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, EMBASE, and Cochrane Library on July 2, 2019 (updated in December, 2020). In vitro studies that included at least two systems for polishing resin composites and analyzed surface roughness were included. The risk of bias was evaluated. A random‐effects Bayesian‐mixed treatment comparison model was used to compare surface roughness in resin composites with the different types of polishers. Surface under the cumulative ranking curve (SUCRA) analysis was performed to rank the probability for the best polishing system. After removal of duplicates, title and abstract screening yielded 34 studies. Network meta‐analysis was not possible for hybrid and microhybrid composites. SUCRA analysis showed that abrasive paper discs allowed greater surface smoothness for nanohybrid and nanofill composites to a probability of between 83% and 91.6%. Silicon carbide brush had a 78.2% probability of being the best system for microfill composites. The use of abrasive paper disc polishers showed a favorable result in nanofill and nanohybrid resin composites. Silicon carbide brush has a greater chance of promoting a smoother surface for microfill resin composites.

Background: The first clinically detectable stage of caries lesion is a non-cavitated white spot lesion (WSL). The detection of early stages of caries lesions allows non-invasive management by fluoride usage, oral hygiene and diet control. There is a lack of information in the literature regarding the prevalence of these caries lesions in preschool children, which is important especially for public health strategies. Objective: The aim of this study was to conduct a systematic review with meta-analysis to verify the WSLs prevalence in primary teeth of preschool children. Methods: A literature search with MEDLINE/PubMed, Scopus, Web of Science, and Open Gray databases was conducted. Included studies fulfilled the eligibility criteria. Meta-analyses were performed using random effects model, for prevalence of pooled WSLs and subgroups analyses. Results: The search strategy identified 4922 potentially relevant articles, with final inclusion of 16 studies. The pooled prevalence of WSLs in primary teeth was 14.0% (95% CI: 8.0-24.0), without publication bias (p=0.2668). For subgroup analyses, an increase in WSLs prevalence for children of low-income economy (24.0%; 95% CI: 20.0-28.0), for age >31 months (22.0%; 95% CI: 12.0-37.0), for validated visual criteria assessment (20.0%; 95% CI: 11.0-33.0), and for tactile assessment with ball-ended probe (26.0%; 95% CI: 11-50.0) were detected. Conclusion: It is suggested that the prevalence of WSLs in primary teeth of preschool children increases in countries with low income economy, with age greater than 31 months or texture assessment with visual validated criteria or ball-ended probe. PROSPERO Registration: Protocol number #CDR42017078434.

The current outbreak of coronavirus 2019 (COVID-19) challenges how professional standards have been defined so far. In Dentistry, biosafety measures already taken by professionals have been intensified, aiming to offer the patient urgent and emergency treatment with safety for both. In this context, Restorative Dentistry is responsible for the care of patients with caries injuries, with or without symptoms and, fractures of teeth and existing restorations. This article guides professionals, during the pandemic period, on the risks involved in adult and pediatric dental care for patients with restorative needs. It also discusses strategies to optimize clinical practice, reducing risks of contamination and virus transmission. Keywords   Operative Dentistry; Dentistry; Biosafety; Pandemics; COVID-19.

Purpose: The aim of this exploratory trial was to compare the 3-month effect of two antimicrobials on the salivary levels of Streptococcus mutans (SM) in children. Materials and Methods: Ninety school children aged 6-10 years participated. They were divided into two groups according to treatment used: 1% chlorhexidine gel (CHX) or 30% silver diamine fluoride (SDF). Saliva for SM colony forming unit (CFU)/ml counting was harvested in four periods: baseline (prior to antimicrobials); P1 (24 h after anti-microbial therapy); P30 (30 days after antimicrobial therapy); and P90 (90 days after antimicrobial therapy). CFU/ml data was submitted to repeated measures by analysis of variance (ANOVA). Results: Only the time factor influenced the results (p 0.05). P30 presented the lowest levels of SM and at P90, SM levels were similar to P1 but still lower than the baseline observations. SDF and CHX presented a similar effect on SM within each period of evaluation (p = 0.65). Conclusion: It was concluded that 30% SDF presents similar antimicrobial effects as 1% CHX over time. SDF might be used as an adjunctive therapy for controlling dental caries in children.

SUMMARY: Objective: To assess the visual perception of observers regarding perceptibility and acceptability of surface gloss variations of resin composites and to determine the limit of perceptibility and acceptability of gloss variations. Methods: Eight resin composite specimens and one human tooth specimen were fabricated. The resin specimens were polished to reach a surface gloss, in gloss units (GUs), of 10 GU, 20 GU, 30 GU, 40 GU, 50 GU, 60 GU, 70 GU, and 80 GU, and the human tooth specimen had a surface gloss of 80 GU. Sixty observers were selected to compare the surface gloss of the specimens in a light booth. For the perceptibility assessment, specimens were randomly displayed two at a time. Each observer performed a total of 144 observations. Observers answered two specific questions for determining the level and limit of perceptibility of gloss variations. The acceptability limit of gloss was determined by comparing the resin specimens with the tooth specimen. The observations were performed with dental practice scenarios (illuminant conditions, visualization field, and observers' education). Data were submitted to a nonlinear probit model and nonlinear regression estimation probit (5%). Results: Differences in perceptibility and acceptability were observed for surface gloss variations (ΔGU) (p30>40>50>60=70). Acceptability and perceptibility limits were 6.4 GU and 35.7 GU, respectively. Conclusions: Perceptibility and acceptability of surface gloss are influenced by gloss variations. A variation of 6.4 GU was required for 50% of observers to notice gloss variations. Concerning acceptability, observers required a variation of 35.7 GU to consider differences in gloss not acceptable.

The purpose of this study was to evaluate the 2-year success of resin composite restorations in non-carious cervical lesions (NCCLs) using the direct or semi-direct techniques. Thirty volunteers presenting with at least two NCCLs were included. Each participant received one restoration using the direct technique and the other using the semi-direct technique, totaling 60 restorations. Time for completing the treatment was computed. Assessments at baseline, 7 days, and 6, 12, and 24 months were performed using the modified United States Public Health Service criteria. Descriptive analysis was reported as a percentage of successful treatments. For inferential analysis, the Student t test was used to evaluate the differences between extension, depth, and time. The chi-square/Fisher tests were used to compare treatment success after each period (α = 0.05). The results were evaluated by using the Kaplan-Meier survival analysis. Differences were detected regarding mean ± standard deviation time, in which direct and semi-direct procedures were accomplished in 21.8 (± 14.5) and 35.3 (± 19.9) min, respectively. Of the 60 restorations placed, 7 failed in the direct group while 8 failed in the semi-direct group up to 2 years. No differences were detected between restorative protocols. The cumulative survival was 88.5% and 88.4% for the direct technique and semi-direct techniques after 24 months, respectively. The tested restorative protocols present similar results for NCCLs within the studied periods. The semi-direct technique exhibited clinical performance similar to direct technique for NCCL, demonstrating an alternative for restorations of these lesions.

Objective: To evaluate the visual perception of surface gloss of resin composite under different illuminants by different observers. Material and methods: twelve cylindrical specimens (6mm x 1mm) were fabricated using a nanofilled resin composite (Z350, A2E shade) in order to compare different observers and to determine the limit of perceptibility of surface gloss. Bovine tooth specimen with similar dimensions was obtained for the comparison of different illuminants. Polishing of resin specimens was performed resulting in 6 groups, presenting surface gloss values at 10, 25, 40, 55, 70, and 85 GU (gloss units), measured by glossmeter (NOVOCURVE). Fifteen individuals were selected: 5 lay-person, 5 undergraduate students, and 5 dental professionals. Participants observed the specimens in a light booth (Gti lightbox) under three different illuminants, and rated the possible combinations between resin specimens or with the bovine enamel specimen (85GU). Data obtained were analyzed by PROBIT non-linear regression analysis (?=0.05). Results: Differences were observed among types of illuminants (p=0.042) and ?GU (p=0.004), with no interaction between factors (p=0.139). The fluorescent light presented lower surface gloss perceptibility values in relation to incandescent light. There was no influence by type of observers (p =0.598). The surface gloss perception limit was 17.6 GU under the presented tested conditions. Conclusion: the illuminant type influenced perception of gloss, with lower percentage of perceptibility for fluorescent light, while such perceptibility was not influence by different observers. Keywords Illuminants; Observer variation; Composite resins; Surface gloss.