Ticiane Cestari Fagundes

Objective: This study aimed to evaluate the adhesive performance of a new self‐cure bulk‐fill restorative system compared with conventional and light‐cured bulk‐fill resin composites after mechanical and thermal cycling. Materials and Methods: Sixty molars were prepared for Class I cavities and restored according to the restorative systems from each group. After 24 h of storage, 30 specimens were sectioned to obtain rectangular sticks (0.9 ± 0.1 mm ² ), which were submitted to microtensile bond strength testing. The remaining specimens were submitted to mechanical cycling; subsequently, beams were thermocycled and tested. Three beams from each group were subjected to nanoleakage testing to obtain illustrative images. Two‐way ANOVA and Tukey's post hoc tests were performed, with a significance level of 5%. Results: No difference on bond strength was observed among groups after 24 h ( p > 0.05). Although all restorative systems showed adhesion reduction, self‐cure bulk‐fill resin composite showed higher values compared to other resin composites after cycling ( p < 0.05). Nanoleakage images revealed a continuous adhesive interface between the self‐cure bulk‐fill composite and dentin, which was maintained after cycling. Conclusions: New self‐cure bulk‐fill resin composite showed initially similar adhesive performance to other restorative systems; however, it demonstrated superior adhesion after mechanical and thermal aging.

This study aimed to evaluate the effects of experimental bioactive glass solutions on dentinal fluid flow and hydraulic conductance in vitro. Dentin blocks of 50 bovine incisors were divided into 5 groups according to the desensitizing agent used (n = 10): Group 1—control (no treatment); Group 2—Bioglass^® 45S5; Group 3—Bioglass^® F18; Group 4—Biosilicate gel; Group 5—Desensibilize Nano P (FGM). Treatments were applied for 20 min daily over 15 days. The specimens were subjected to a citric acid challenge to simulate oral demineralizing conditions. Dentinal fluid flow and hydraulic conductance were evaluated before and after the desensitizing procedures and the acidic challenge. Scanning electron microscopy (SEM) provided qualitative dentin surface analysis. Dentinal fluid flow and hydraulic conductance data were analyzed by two-way repeated measures ANOVA and Tukey’s test (α = 0.05). The control group showed the highest dentinal fluid flow and hydraulic conductance values after the acid challenge (p < 0.05). After product application, Bioglass^® 45S5 and Bioglass^® F18 showed the lowest dentinal fluid flow (0.463 ± 0.124 Lp and 0.549 ± 0.239 Lp, respectively) and hydraulic conductance values (0.025 ± 0.007 Lp and 0.026 ± 0.007 Lp, respectively), differing significantly from Biosilicate Gel and Desensibilize Nano P (p < 0.0001). Biosilicate Gel and Desensibilize Nano P showed higher dentinal fluid flow (0.864 ± 0.180 Lp and 0.840 ± 0.173 Lp, respectively) and hydraulic conductance values (0.047 ± 0.010 Lp and 0.046 ± 0.009 Lp, respectively) after application (p < 0.0001). After the acid challenge, no significant differences were observed among the groups (p > 0.05), although all experimental groups showed numerically lower values than the control group. Bioactive glass-based desensitizing agents reduced dentinal fluid flow and hydraulic conductance, suggesting dentinal tubule occlusion. Bioglass^® 45S5 and Bioglass^® F18 showed the most stable performance, maintaining lower values even after the acid challenge, suggesting potential for the management of dentin hypersensitivity.

This longitudinal, randomized, parallel-design clinical trial aimed to evaluate the long-term effectiveness of different in-office treatments for dentin hypersensitivity (DH) over a 6-month period. A total of 192 teeth presenting DH associated with root surface exposure were treated with one of four desensitizing agents: fluoride varnish (Duraphat – FLU, active control), bioactive ceramic solution (Biosilicate – BIOS), universal self-etching adhesive (Single Bond Universal – SBU), and a bioactive, photoactivated varnish containing PRG fillers (SPRG). DH was assessed using a visual analogue scale (VAS) to analyse intensity of sensitivity and a computerized visual scale (CoVAS) to observe the time course of sensibility at baseline, 7, 15, 30 days and 6 months post-treatment. Comparisons between groups were conducted using Fisher’s exact test for qualitative variables and analysis of variance (ANOVA) for quantitative variables. Longitudinal outcomes (VAS and CoVAS) were evaluated using linear mixed-effects models, with post hoc comparisons performed using orthogonal contrasts. Statistical differences were found for VAS analysis (p < 0.05). Comparing the desensitizers, FLU showed higher sensitivity than SBU, after 7 days. Comparing follow-up periods, a significant reduction in DH beginning at 7 days for BIOS and SBU, and at 15 days for FLU and SPRG. Regarding CoVAS time course, FLU exhibited a significantly shorter time course than SBU, after 15 days and 6 months of follow-up (p ≤ 0.05). SPRG was the only treatment that showed no difference in reaction time between 6 months and baseline (p > 0.05). In conclusion, root exposure height and the presence of an antagonist tooth may influence the initial intensity of DH. All treatments reduced DH over 6 months. Only bioactive resin varnish maintained the same reaction time in all periods. Universal adhesive system had slowed pain reaction time compared to conventional fluoride varnish.

Several adhesion strategies have been proposed for restoring non-carious cervical lesions (NCCLs). Long-term clinical trials are essential to guide clinicians toward the most effective approach. To evaluate the 5-year clinical performance of NCCLs restored using different adhesion strategies. Four strategies were assessed: an adhesive system (Scotchbond Universal; SBU/Filtek Z350XT) applied without (SBU) and with selective enamel conditioning (E-SBU), and a resin-modified glass-ionomer cement (Vitremer; RMGIC) applied without (RMGIC) and with ethylene-diaminetetraacetic acid pretreatment (E-RMGIC). Two hundred restorations were evaluated using United States Public Health Service criteria after 5 years. Kappa test, Wilcoxon Signed-Rank test, Kaplan-Meier analysis, equality tests of two proportions, and multiple logistic regression were applied (α = 0.05). One hundred and nineteen restorations were re-evaluated after 5 years. No significant differences were observed in restoration survival among groups. E-SBU exhibited more Bravo scores for marginal integrity compared to the ionomer groups and for marginal discoloration compared to RMGIC. Ionomer groups had higher Bravo scores for surface texture. RMGIC showed greater wear than E-SBU, being statistically similar to SBU. No significant differences were found for color and secondary caries over time. Multiple logistic regression analysis revealed that restoration retention was significantly influenced by the type of tooth (premolars), the degree of dentin sclerosis, and the degree of marginal tissue recession. All four adhesion strategies demonstrated similar 5-year survival. Marginal defects were more frequent in the selective enamel etching group than in ionomeric restorations. Surface luster was reduced in ionomer restorations. The retention of NCCL restorations may be affected by tooth type, degree of dentin sclerosis, and marginal tissue recession. The four adhesion strategies had similar survival after 5 years; however, composite resin restorations applied after selective enamel etching promote more initial marginal defects than ionomer-based restorations following the manufacturer's instructions. Clinical factors such as lesion location, dentin sclerosis, and gingival recession can influence the retention of NCCL restorations.

O cimento de ionômero de vidro (CIV) é um material resultante da combinação entre ácidos poliméricos associados ao pó de vidro inorgânico. Desde a sua introdução em meados de 70 por Wilson e Kent, muitas foram as modificações em busca de aperfeiçoamentos em sua composição e propriedades. O CIV é amplamente utilizado em diversas áreas da Odontologia e seu sucesso se deve, principalmente, à liberação de flúor e sua biocompatibilidade, que configuram o caráter benéfico intrinsecamente ligado aos preceitos preventivos e de técnicas minimamente invasivas da odontologia restauradora. Tomando por base sua natureza físico-química e composição, se dá sua classificação em: cimentos convencionais, cimentos reforçados por partículas de metal, cimentos modificados por resina, cimentos de alta viscosidade e, ainda, cimentos híbridos de vidro. O propósito deste trabalho é revisar a literatura conceitual relacionada ao CIV, abordando tendências atuais de pesquisas, com enfoque na tecnologia híbrida de vidro, norteando o cirurgião-dentista em sua prática clínica. Assim como, descrever um caso clínico demonstrando a utilização do cimento híbrido de vidro, onde um paciente do sexo masculino, com 19 anos, apresentou-se à Faculdade de Odontologia de Araçatuba, insatisfeito com a estética do seu sorriso e com cárie dentária localizada nos dentes maxilares e mandibulares. Inicialmente, o paciente recebeu instruções sobre higiene bucal e adequação da dieta, com o objetivo de promover mudanças de hábitos que contribuam para a eficácia do tratamento a longo prazo. Posteriormente, as lesões cariosas foram removidas com colheres e curetas de dentina. Em sequência, foram feitos limpeza e condicionamento das cavidades. Para a restauração das lesões de cárie, foi utilizado material restaurador híbrido de vidro (Equia Forte, GC, Tóquio, Japão). Uma vez realizados os procedimentos de remoção e restauração de todas as lesões de cárie, o paciente passou a ser mensalmente monitorado e constantemente retomadas as orientações preventivas de higiene bucal e dieta. Concluindo que os CIVs são materiais de grande relevância na prática clínica, considerando suas propriedades físico-químicas superiores, como a capacidade de recarga e a liberação contínua de flúor nas regiões adjacentes à sua aplicação. O material restaurador apresentou comportamento clínico estável após 8 meses de acompanhamento. Conforme demonstrado na literatura, embora os CIVs apresentem limitações clássicas, como baixa resistência mecânica e estética insatisfatória, avanços significativos vêm sendo alcançados nos últimos anos. O sistema EQUIA Forte configura-se como uma importante inovação, desenvolvida com o objetivo de aprimorar as propriedades físicas iniciais desses materiais, sem abrir mão das vantagens inerentes aos CIVs convencionais. Dessa forma, os CIVs reafirmam sua relevância na prática odontológica contemporânea, especialmente por suas propriedades físico-químicas superiores, como a capacidade de recarga e a liberação contínua de flúor nas regiões adjacentes à sua aplicação, favorecendo a prevenção de cáries secundárias e promovendo a longevidade dos tratamentos.

Purpose: To compare the color alteration, surface roughness and microhardness and cross‐sectional microhardness of bovine enamel treated with at‐home whitening strips and gels. Materials and Methods: Sixty‐six pigmented specimens ( n = 11) were allocated to six groups: C—cotton wool moistened with distilled water for 1 h; SDS—sodium dithionite strip, for 1 h; HPS—6.5% hydrogen peroxide strip, for 1 h; CPS—20% carbamide peroxide strip, for 1 h; HPG—7.5% hydrogen peroxide gel, for 1 h; CPG—10% carbamide peroxide gel, for 4 h. The treatments lasted 10 days, calculating the ∆E, ∆ E ₀₀ , and ∆ W _ID at baseline, 5 and 10 days, and 14 days after completion. Additional 66 polished discs ( n = 11) were used to analyze the surface roughness and microhardness of enamel before and after bleaching, cross‐sectional microhardness and integrated mineral loss (ΔZ; %Vol × μm). Data were subjected to statistical analysis by two‐way Anova RM and Tukey post‐test ( α = 0.05). Results: In ∆E and ∆W _ID analysis, greater values were obtained in CPG ( p < 0.001), followed by HPG and HPS ( p = 0.271). SDS and CPS ( p < 0.001) exceeded only C ( p < 0.001). In ∆ E ₀₀ , at completion of treatments, the results were similar; however, HPG = HPS = CPS ( p = 0.237). There was an increase in roughness and decrease in surface microhardness in all bleaching groups ( p < 0.005). Concerning the cross‐sectional microhardness, the treatments were equal to C at 150 μm, the last depth analyzed. For Δ Z , the values of SDS, CPS, HPG, and CPG groups showed similar mineral loss ( p > 0.001), and the lowest value was exhibited in the Control group, followed by HPS group ( p < 0.001). Conclusion: Although the strips were aesthetically effective, the CPG and HPG groups presented highest values in the ∆ E ₀₀ and ∆ W _ID analysis. However, all treatments influenced the enamel surface, increasing roughness and decreasing surface and transverse microhardness. Clinical Relevance: The whitening gels promoted greater chromatic changes, but all treatments affected the enamel surface, increasing roughness and decreasing surface and transverse microhardness.

This in vitro study aimed to evaluate the effect of violet LED and argon plasma, associated or not with oxygen, on chromatic alteration, whitening index, temperature variation, wettability, surface energy, total free interaction energy, and adhesive strength in dentin tissue. Thus, 100 bovine dentin discs were allocated to 5 groups (n=20): C - control; APL - argon plasma; APL+O - argon plasma + 3% oxygen; LED - violet LED; HP - 35% hydrogen peroxide. In the first bleaching treatment for each technique, chromatic alteration (ΔE₀₀), bleaching index (ΔW_ID), and temperature variation were analyzed. Subsequently, the specimens were repolished, receiving the surface treatments again and designated for contact angle (^o), surface energy (γs), and total free interaction energy (ΔG) analyses (n=5). In contrast, the remaining specimens were restored for bond strength analysis (n=15). From each specimen, four beams were obtained, two evaluated immediately and two after 10,000 thermal cycles. Bond strength data were subjected to 2-way repeated measures ANOVA, and the other analyses to 1-way ANOVA with Tukey's post hoc test (α=0.05). APL+O presented bleaching efficacy similar to the HP group, which, in turn, had the lowest bond strength values (pΔG values. APL and APL+O showed bond strength values that surpassed only those of the control group. It was concluded that plasma treatments were effective in dentin bleaching; however, none of the evaluated therapies managed to prevent the loss of bond strength.

This study investigated the influence of chitosan and nanodiamond incorporation on the surface, optical, and mechanical properties of glass ionomer cement. Total 56 samples (5 mm diameter and 2 mm thickness) were prepared and divided into 4 groups according to the incorporation of chitosan and nanodiamond on Fuji II glass ionomer cement: Control group: no incorporation; 10%CH group: incorporation of 10% chitosan; 10%ND group: incorporation of 10% of nanodiamond; 5%CH-5%ND group: incorporation of 5% chitosan and 5% nanodiamond (n=14). Analyses of color stability, surface roughness, fluorescence intensity, microhardness, morphology, and chemical composition were investigated. Additionally, water sorption, hygroscopic expansion, contact angle, surface free energy, and total free energy of interaction were also assessed. After the initial readings, the samples were individually stored in red wine solution for 28 days. Data were subjected to ANOVA followed by Tukey´s test (α=.05). Aging in wine solution altered the optical, mechanical, and surface properties of glass ionomer cement regardless of the incorporation of the compound (P<.05). 10% chitosan-incorporated glass ionomer cement promoted higher color alteration, surface roughness, and water sorption after aging (P<.05). 10% nanodiamond-incorporated glass ionomer cement showed higher microhardness compared to the other groups before aging (P<.05), however there were no differences among them after aging (P>.05). In general, no differences between the 5% chitosan- and 5% nanodiamond-incorporated glass ionomer cement and control groups were noted on the evaluated analyses (P>.05). Thus, the incorporation of 5% chitosan and 5% nanodiamond is a satisfactory alternative for maintain the surface, optical, and mechanical properties of the glass ionomer cement.

A preocupação crescente com a sustentabilidade na esfera da saúde tem fomentado o desenvolvimento de alternativas ecologicamente conscientes, como as escovas de bambu, frente ao impacto ambiental das escovas de dentes feitas de plástico. Assim, o objetivo deste estudo foi avaliar a percepção a respeito do descarte de escovas de dentes manuais de plástico e noções de práticas sustentáveis relacionadas ao uso de dispositivos alternativos como a escova de bambu. Para isso, foi aplicado um questionário estruturado a 120 pacientes e acompanhantes da Faculdade de Odontologia de Araçatuba (FOA-UNESP). Os resultados revelaram que 67,5% dos participantes descartam imediatamente suas escovas, com 98,3% dos descartes ocorridos no lixo comum, demonstrando baixo conhecimento sobre os danos ambientais gerados por esses produtos. Além disso, nenhum entrevistado usava escovas de bambu, e cerca de 80% desconheciam sua existência. Fatores como nível de escolaridade, renda familiar e gênero tiveram influência significativa nas práticas e percepções sobre o consumo sustentável. Portanto, é possível concluir que esses resultados reforçam a necessidade de campanhas educativas que promovam a conscientização ambiental, bem como a adoção de práticas adequadas de descarte e reutilização desses materiais, contribuindo para a mitigação dos impactos ambientais associados ao uso desses produtos odontológicos.