Isabel Cristina Olegário

Mechanical properties of high-viscosity glass ionomer cement and nanoparticle glass carbomer

Introduction. The lack of evidence regarding the best available material for restoring occlusal-proximal cavities in primary teeth leads to the development of new restorative material, with nanoparticles, in order to enhance mechanical properties, resulting in increased restoration longevity. Aim. To evaluate the Knoop hardness and bond strength of nanoparticles material glass carbomer cement (CAR) and high-viscosity glass ionomer cement (GIC) in sound and caries-affected dentin. Methods. Forty bovine incisors were selectedand assigned into four groups (n = 10): SGIC, sound dentin and GIC; SCAR, sound dentin and CAR; CGIC, caries-affected dentin andGIC; and CCAR, caries-affected dentin and CAR. All groups were submitted to microshear bond strength (MPa). Knoop hardness was also performed. Bond strength values were subjected to two-way ANOVA and Tukey test. Knoop hardness data were subjected to one-way ANOVA. Results. GIC presented higher Knoop hardness (p < 0.001) and bond strength (p = 0.027) than CAR. Also, both materials showed better performance in sound than in caries-affected substrates (p = 0.001). The interaction between factors was not statistically different (p = 0.494). Conclusion. Despite nanoparticles, CAR shows inferior performance as compared to GIC for the two properties tested in vitro. Moreover, sound dentin results in better bonding performance of both restorative materials evaluated.

Low-cost GICs reduce survival rate in occlusal ART restorations in primary molars after one year: A RCT

INTRODUCTION The high costs of the worldwide recommended GICs might be a barrier for the implementation of ART. To overcome this problem, low cost GIC are used even though there is a lack of evidence for the survival rate of restorations. OBJECTIVES To evaluate the performance of low-cost GICs used on occlusal ART restorations after one year. METHODS A total of 150 primary molars in 150 children with occlusal caries lesions were selected in 4-8 year-old children. The patients were randomly allocated in three groups: G1-GC Gold Label 9 (GC Corp); G2-Vitro Molar (DFL) and G3-Maxxion R (FGM). All treatments were performed following the ART premises in school setting. Restorations were evaluated after 2, 6 and 12 months. Restoration survival was evaluated using Kaplan-Meier survival analysis and Log-rank test and Cox regression was used for testing association with clinical factors (α=5%). RESULTS GC Gold Label 9 had better performance compared to the low-cost GICs (HR=1.47, CI=1.04-2.08, p=0.027). The overall SR of restorations was 65.33% and the SR per group was G1=77.55%; G2=61.11% and G3=42.55%. CONCLUSIONS The low-cost GICs have a poorer performance than GC Gold Label 9 in occlusal ART restoration in primary molars.

Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial

Introduction Despite the widespread acceptance of conventional treatment using composite resin in primary teeth, there is limited evidence that this approach is the best option in paediatric clinics. Atraumatic restorative treatment (ART) using high-viscosity glass ionomer cement has gradually become more popular because it performs well in clinical studies, is easy to handle and is patient friendly. Therefore, the aim of this randomised clinical trial study is to compare the restoration longevity of conventional treatment using composite resin with that of ART in posterior primary teeth. As secondary outcomes, cost-efficacy and patient self-reported discomfort will also be tested. Methods and analysis Children aged 3–6 years presenting with at least one occlusal and/or occlusal-proximal cavity will be randomly assigned to one of two groups according to the dental treatment: ART (experimental group) or composite resin restoration (control group). The dental treatment will be performed at a dental care trailer located in an educational complex in Barueri/SP, Brazil. The unit of randomisation will be the child. A sample size of 240 teeth with occlusal cavities and 188 teeth with occlusal-proximal cavities has been calculated. The primary outcome will be restoration longevity, which will be clinically assessed after 6, 12, 18 and 24 months by two examiners. The duration of the dental treatment and the cost of all materials used will be considered when estimating the cost-efficacy of each treatment. Individual discomfort will be measured after each dental procedure using the Facial Scale of Wong-Baker. Ethics and dissemination This clinical trial was approved by the local ethics committee from the Faculty of Dentistry of the University of São Paulo (registration no. 1.556.018). Participants will be included after their legal guardians have signed an informed consent form containing detailed information about the research. Trial registration number www.clinicaltrials.gov, NCT02562456; Pre-results.

The Atraumatic Restorative Treatment

With the aim of providing dental treatment in field conditions, where no electricity or running water was available, the atraumatic restorative treatment (ART) was developed. Nowadays, numerous clinical trials and systematic reviews show its efficacy not only under those conditions but also as a treatment option for pediatric dentistry dental offices. Besides dental hygiene and sugar consumption advice, ART involves restorations using only hand instruments for carious tissue removal and also pit and fissure sealants. To ensure the restoration and sealant survival, high-viscosity glass ionomer cement must be used, followed by the finger-press technique. ART has been shown to be a less painful, effective, and child-friendly treatment, with comparable survival to conventional treatment. This chapter provides an overview of the ART technique, clinical indications, and the current scientific evidence to support its use.

Benign vascular lesions of the lips: Diagnostic approach

Although not rare, vascular lesions occurring in the lips sometimes poses a difficult in properly diagnosing and handling them. In this study, vascular lesions occurring in the lips were retrieved from an Oral Pathology Service.