Anabela Paula

Reabilitações Estéticas Complexas Baseadas na Proporção Aúrea

Resumo As definicoes das leis da beleza e harmonia foram uma constante preocupacao dos filosofos e matematicos gregos. Para eles, a conexao da beleza com os valores numericos, segue a filosofia de que a beleza e sempre fundamentalmente exacta. Este pressuposto baseia-se na teoria da divina proporcao ou proporcao aurea, a qual foi formulada por Pitagoras a partir de elementos utilizados por Euclides, em que duas partes desiguais possuem relacoes harmonicas. Objectivos da apresentacao Esta apresentacao tem como objectivo efectuar uma revisao sobre os varios metodos de calculo da divina proporcao, para facilitar reabilitacoes complexas de dentes anteriores assimetricos. Materiais Os casos clinicos efectuados utilizaram varios sistemas adesivos (Prime& Bond ® - Dentsply; One Coat Bond ® - Coltene/Whaladent) e de resinas compostas indicadas para dentes anteriores (Artemis ® - Ivoclar/Vivadent, Miris ® - Coltene/Whaladent; Ceram X Duo ® - Dentsply; Enamel HFO Plus - Micerium). Metodos Os valores lineares da proporcao aurea podem ser aplicados nas formas unilateral e bilateral, de acordo com as variacoes das relacoes quantitativas das composicoes dentaria, dentofacial e facial. Esta apresentacao baseia-se numa analise bibliografica qualificada e variada de 1996–2005, de publicacoes de varios autores e artigos cientificos publicados em revistas da especialidade. Conclusao Os metodos de calculo utilizados para a realizacao das restauracoes anteriores complexas, descritos nesta apresentacao, facilitam a obtencao da harmonia e simetria finais, diminuindo o tempo de acabamento, consequentemente o tempo de cadeira.

Effects on gastric mucosa induced by dental bleaching – an experimental study with 6% hydrogen peroxide in rats

The value of aesthetic dentistry has precipitated several developments in the investigation of dental materials related to this field. The free marketing of these products is a problem and it is subject to various interpretations regarding its legality. There are several techniques for tooth whitening, the most used one being the external bleaching. It is the later version of such technique that poses the greatest danger of ingesting the product. The present study analysed the systemic effect of these products when they are swallowed. Objective This experimental study aimed to observe the effects of a tooth whitening product, whose active agent is 6% hydrogen peroxide, on the gastric mucosa of healthy and non-tumour gastric pathology animals. Material and Methods Fifty Wistar-Han rats were used and then distributed into 5 groups, one for control and four test groups in which the bleaching product was administered in animals with and without non-tumour gastric pathology (induced by the administration of 1 sample of 50% ethanol and 5% of drinking water during 6 days) at different times of study by gavage. There was a decrease in body weight in animals of groups handled during the study period, which was most pronounced in IV and VA groups. Changes in spleen weight relative to body weight revealed no statistically significant changes. An analysis of the frequency was performed on the results of macroscopic observation of the gastric mucosa. Results The gastric mucosa revealed lesions in all manipulated groups, being more frequent in groups III and IV. It appears that there is a synergism when using hydrogen peroxide and 50% ethanol in the same group. Conclusion Therefore, it seems that there are some signs of toxicity 3 to 4 days after administration of 6% hydrogen peroxide. The prescription of these therapies must be controlled by the clinician and the risks must be minimized.

Therapies for White Spot Lesions—A Systematic Review

Introduction The first sign of dental caries is denoted by white spot lesions (WSLs) which can be defined as a demineralization of the enamel surface and subsurface, although these lesions can be reversed and do not form cavities. The aim of this systematic review was investigate which remineralization agents are effective for the treatment of WSLs. Materials and Methods For this systematic review a literature search was conducted on Pubmed, Cochrane Library and ScienceDirect. Results The initial search resulted in 273 references. After elimination of duplicate articles, 236 references remained. After reading titles and abstracts, all non‐relevant results were excluded, resulting in 45 potentially relevant studies. After reading the full text, 13 references were included. Conclusion More studies are required for scientific evidence in order to reach a conclusion of the most suitable therapeutic method for the treatment of surface and subsurface demineralization of the enamel.

Dental caries and bacterial load in saliva and dental biofilm of type 1 diabetics on continuous subcutaneous insulin infusion

Abstract Objectives Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump. Material and Methods Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR. Results Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm. Conclusion Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program.

Roughness and microhardness of composites after different bleaching techniques

Background The aim of this study was to evaluate the roughness and microhardness of SonicFill™ (Kerr), and compare it with Filtek™ Supreme XTE (3M ESPE) after 2 bleaching regimens. Methods Sixty cylindrical specimens (10 × 2 mm) of each of the 2 composites were prepared and divided into 6 groups (n = 20): groups 1, 2: no treatment; groups 3, 4: 10% carbamide peroxide (CP); and groups 5, 6: 35% hydrogen peroxide (HP) plus LED. After treatments, specimens were thermocycled (500 cycles, 5°C/55°C, dwell time 30 minutes). A mechanical roughness tester was employed to measure the surface roughness parameters and the Vickers test to measure microhardness. One-way ANOVA, Tukey and Bonferroni methods with a significance level of 5% were used for the statistical analysis. Results For SonicFill™, there was no statistically significant difference in microhardness between the control group (no. 1) and the bleached groups (nos. 3, 5), but there was difference between CP and HP treatments; for Filtek™ Supreme XTE, there was no significant difference in microhardness among all groups. There was no significant difference in average roughness (Ra) and the root mean square of the roughness (Rq) among all groups. The mean roughness depth (Rz) parameter showed no statistically significant differences among all groups for SonicFill™, but in Filtek™ Supreme XTE, there was a significant increase between control and bleaching treatments; roughness skewness (Rsk) showed no statistically significant differences among all groups for SonicFill™ and Filtek™ Supreme XTE, except for nos. 2 and 4, where the Rsk increased with CP. Conclusions The microhardness of Filtek™ Supreme XTE is less affected by bleaching than that of SonicFill™. Both bleaching treatments affect Rz in Filtek™ Supreme XTE in contrast to SonicFill™, but only the CP treatment affects the Rsk of Filtek™ Supreme XTE, with no significant effect of SonicFill™.

Restaurações Seriadas em Dentes Posteriores com Recurso às Matrizes Oclusais

Resumo: As resinas compostas tornaram-se, nos ultimos tempos, o material restaurador mais utilizado para dentes posteriores. A busca constante da reproducao da anatomia oclusal nesses casos e um dos maiores desafios para se obter um resultado satisfatorio. A tecnica da matriz oclusal confeccionada com polivinil siloxano transparente, cujo objectivo e a copia da superficie oclusal foi proposta para se obter uma melhoria na anatomia final da restauracao e, ainda, diminuir a fase de acabamento e polimento e o tempo clinico empregue. Sendo assim, o objectivo deste artigo e descrever passo a passo a tecnica usada em restauracoes de dentes posteriores seriadas e concluimos que e um metodo confiavel e previsivel para a reconstrucao da anatomia oclusal, obtendo assim, um melhor acabamento e polimento, sem necessidade de realizar desgastes finais. Palavras-Chave: Dentes posteriores; Estetica; Matriz oclusal; Resina composta

Terapêuticas Estéticas Integradas no Âmbito da Dentistaria Operatória

Resumo Os autores descrevem a tecnica de restauracao de dentes anteriores com recurso a uma matriz palatina de silicone de adicao, confeccionada num modelo de estudo. Foi escolhida para todos os casos a tecnica restauradora por estratificacao e com resinas compostas microhibridas. Sao referidas ainda, algumas terapeuticas de branqueamento realizadas em casos clinicos sem indicacao para restauracao com resina composta, e noutros, em que estas devem ser realizadas previamente as terapeuticas restauradoras. Assim, podemos optar por branqueamento externo em ambulatorio ou no consultorio activado por luz emitida por um aparelho de tecnologia LED, ou ainda, em alguns casos, branqueamento interno/externo. Em qualquer das terapeuticas pode ser necessario realizar restauracoes esteticas anteriores. Nos casos clinicos apresentados utilizou-se o peroxido de hidrogenio a 25% para branqueamento activado com luz de um aparelho de tecnologia LED (Discus Dental Zoom Chairside System®) e o peroxido de carbamida a 10% e uma moldeira individual para branqueamento externo em ambulatorio. O branqueamento interno/externo foi realizado igualmente em ambulatorio e com moldeira com peroxido de carbamida a 10%. Os autores concluem que: 1 - a tecnica restauradora por estratificacao com recurso a matriz palatina apresenta resultados esteticos satisfatorios; 2 - qualquer das tecnicas de branqueamento permite, quando indicado, melhorar os resultados esteticos finais.

Reabilitação Estética Anterior: a Propósito de um Caso Clínico☆

Resumo A presenca de multiplas lesoes dentarias compromete significativamente a funcao e a estetica do paciente. A prevalencia de lesoes cervicais (cariosas e nao cariosas) e grande em adultos e a sua severidade aumenta com a idade. Com este trabalho pretende-se abordar as lesoes classes V, identificar os diferentes factores etiologicos, caracterizalas e diagnostica-las, e ainda, apresentar o protocolo de tratamento. De acordo com a revisao bibliografica efectuada e o caso clinico apresentado, concluiu-se que as lesoes classe V apresentam uma etiologia multifactorial e que o sucesso do tratamento restaurador esta directamente relacionado com a eliminacao da causa, bem como com a escolha do material restaurador adequado

Direct Pulp Capping: What is the Most Effective Therapy?—Systematic Review and Meta-Analysis

Introduction Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was to compare the effectiveness of biomaterials and techniques by means of a systematic review and meta‐analysis. Methods The PubMed, Cochrane, and Embase databases were used to search the literature published from January 1, 1980 until August 31, 2017. Studies that met inclusion criteria were screened by 2 authors individually. The meta‐analysis was performed on mineral trioxide aggregate (MTA) cement vs calcium hydroxide cement, tricalcium silicate cement vs MTA cement, and adhesive systems vs CaOH cement and evaluated the success rate, inflammatory response, and dentin bridge formation. Results Forty‐six studies were included in the systematic review, while 22 studies were included in the meta‐analysis. There was no significant heterogeneity between the studies. MTA cements showed a significantly higher success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 2.72; 95% confidence interval [CI] = 1.90‐3.90; P = 0.000). However, when compared with the tricalcium silicate cements, there were no statistically significant differences (odds ratio = 1.18; 95% CI = 0.53‐2.65; P = 0.672). Adhesive systems showed a significantly lower success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 0.062; 95% CI = 0.024‐0.157; P = 0.000). Conclusions MTA cements have a higher success rate, with a lower inflammatory response and a more predictable hard dentin barrier formation than calcium hydroxide cements. However, there were no differences, in these parameters, when MTA cement was compared with tricalcium silicate cements. Dental adhesives systems showed the lowest success rates.

Prevalence of Dental Caries in Patients with Type 1 Diabetes Mellitus Treated with Multiple Insulin Injections and that of Individuals without Diabetes

INTRODUCTION In addition to macro and microvascular complications that are associated with the disease, hyperglycaemia is also a risk factor for several oral complications. The aim of this study is to establish a relationship between dental caries in patients with type 1 diabetes mellitus treated with multiple insulin injections and that of individuals without diabetes. It is also an aim to characterize the oral hygiene habits of this population. MATERIAL AND METHODS An observational clinical study of analytical and cross-sectional nature was conducted. Thirty patients with type 1 diabetes mellitus and 30 individuals without diabetes were observed and questioned about information regarding their medical history. Oral examination was conducted according to the standards of the World Health Organization and ICDAS was used for caries detection. Statistical analysis was performed and the significance level was set at 5%. RESULTS Patients with diabetes mellitus showed similar caries levels to that of individuals without diabetes. Patients with diabetes mellitus had a higher dental plaque index. Only 10% of the patients having episodes of nocturnal hypoglycaemia brush their teeth after glucose intake. DISCUSSION Although theres some controversy in the literature regarding the prevalence of caries in patients with diabetes mellitus, the results are in agreement with a great number of studies. However, patients with diabetes mellitus have a higher plaque index which can be associated with a higher risk for developing certain oral pathologies. CONCLUSION No statistically significant association was found between type 1 diabetes mellitus and dental caries.