Isauremi Vieira de Assunção Pinheiro

Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomised controlled clinical trial

OBJECTIVE This study aimed to evaluate the progression of sealed non-cavitated dentinal occlusal caries in a randomised controlled clinical trial. MATERIALS AND METHODS Sixty teeth with non-cavitated dentinal occlusal caries were selected in patients with a high risk for caries. Patients were randomly divided into two groups so that each group included 30 teeth. Patients in the experiment group were given oral hygiene instructions and a fissure sealant. Patients in the control group were given oral hygiene instructions only. Caries progression and sealant loss were monitored over a period of 36 months by clinical and radiographic examinations. RESULTS Clinical and radiographic progression of caries was significantly more frequent in the control group than in the experiment group. Three teeth lost their sealant and showed caries progression, but this was apparent only at the 12-month follow-up. At the 24- and 36-month recall appointments, neither sealant loss nor caries progression were observed. CONCLUSION The pit and fissure sealant utilised in this study was shown to be effective in arresting carious lesions at 36 months.

Microbiota of dentinal caries as assessed by reverse-capture checkerboard analysis.

Background/Aims: This study aimed to identify the microbiota of different layers of dentinal caries by using a culture-independent molecular biology approach. Methods: DNA was extracted from samples taken from 3 distinct layers (superficial, middle and deep) of advanced occlusal caries and analyzed for the presence and relative levels of 28 oral bacterial species/phylotypes using a reverse-capture checkerboard hybridization assay. Results: The mean number of target taxa per layer was 7.7 (±3.96) in the superficial, 7 (±3.4) in the middle, and 6.3 (±3.04) in the deep layer. No statistical significance was observed for these differences (p = 0.36). Overall, the most prevalent taxa in the 3 layers were Atopobium genomospecies C1 (72.5%), Fusobacterium nucleatum (69%), Lactobacillus casei (68%), Veillonella species (55%) and Lactobacillus fermentum (52%). No differences were found in the prevalence rates of the most frequent target species in the 3 layers. The most prevalent taxa found at levels above 105 in the advanced front line of deep-dentin caries were Atopobium genomospecies C1, F. nucleatum, Streptococcus mutans, Streptococcus species and Veillonella species. Conclusion: The present results revealed that the prevalences of several established or candidate caries pathogens do not differ significantly in the different zones of dentinal caries lesions. The finding that some as-yet-uncharacterized species and novel species were found in high frequencies join other molecular studies to include them in the set of candidate caries pathogens.

Efficacy of a non-drilling approach to manage non-cavitated dentin occlusal caries in primary molars: a 12-month randomized controlled clinical trial.

BACKGROUND. Despite the efficacy of non-drilling approaches to manage non-cavitated dentin occlusal lesions (NCDOL) in permanent teeth, there is no data validating this type of therapy in the primary dentition. AIM. To compare the efficacy of a traditional fissure sealant in managing NCDOL in primary molars. DESIGN. This study is a randomized controlled clinical trial with a split-mouth design. Thirty schoolchildren with two NCDOL were selected and divided into two groups. The experimental group received a resin-based fissure sealant, whereas the control group was treated with a conventional composite resin. Treatment efficacy was evaluated after 1 year by means of clinical and radiographic examinations. RESULTS. The two treatment modalities were found to be similarly effective in managing DONCL in primary molars. CONCLUSION. For the management of non-cavitated dentin occlusal caries in primary teeth, the invasive approach can be replaced with non-drilling fissure sealing techniques.

Effect of irradiation times on the polymerization depth of contemporary fissure sealants with different opacities

The aim of this study was to evaluate the depth of curing of 10 contemporary blue light-activated dental flowable materials at several opacities, influenced by different irradiation times using FT-IR spectroscopy. Fifty-five specimens (n = 5) with a 5-mm diameter and 1-mm thickness of translucent (Opallis Flow T), yellowed (Master Flow A2; Opallis Flow A2; Natural Flow A2; Fluroshield Yellowed), and opaque materials (Master Flow OA2; Natural Flow O; Opallis Flow OA3.5; Opallis Flow OP; Fluroshield White) were obtained at six curing times (10s, 20s, 30s, 40s, 50s, and 60s) using a high-intensity LED (Coltolux, Coltène/Whaledent). The degree of conversion (DC) (%) was obtained using the Nexus 470 FTIR Spectrometer (Nicolet Instruments, USA). The FTIR-ATR spectra for uncured and cured samples were analyzed using a ZnSe crystal. The top and bottom surfaces of the cured specimens were analyzed to obtain the depth of curing. Two-way ANOVA was used to analyze the data. The highest curing depth was obtained by Natural Flow OA2, while the lowest was shown by Master Flow OA2. The shortest curing time generated similar depths of cure in comparison with the most extensive for Opallis Flow A2 and Fluroshield Yellowed. Therefore, depth of curing, influenced by the irradiation time, was dependent on the materials. Using the Natural Flow OA2 opaque sealant and the 10-s curing time for Opallis Flow A2 and Fluroshield Yellowed may represent alternative approaches to sealing tooth fissures.

Preliminary study of a novel in-office bleaching therapy modified with a casein phosphopeptide-amorphous calcium phosphate.

Although in‐office bleaching has been proven successful for bleaching teeth, controversy exists from morphological alterations in enamel morphology due to mineral loss and tooth sensitivity. This preliminary study aimed to evaluate the efficacy of a novel in‐office tooth bleaching technique modified with a casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) paste (MI paste—MI) and its effect on the enamel morphology and tooth sensitivity. Three patients received a 35% hydrogen peroxide (Whiteness HP—HP) dental bleaching system. HP was prepared and applied on the teeth on one of the hemiarches, whilst teeth on the other hemiarch were bleached with a mixture of HP and MI. Tooth color, epoxy resin replicas, and sensitivity levels were evaluated in the upper incisors. The results were analyzed descriptively. Right and left incisors showed similar color change after bleaching. Incisors bleached with the mixture of HP and MI presented unaltered enamel surfaces and lower sensitivity levels. The currently tested tooth bleaching technique did not reduce the gel effectiveness while decreasing hypersensitivity levels and protecting the enamel against surface alterations caused by the high‐concentration bleaching peroxide tested. The concomitant use of MI Paste and high‐concentration hydrogen peroxide might be a successful method for decreasing tooth sensitivity and limiting changes in the enamel morphology during in‐office bleaching. Microsc. Res. Tech. 2012.

Use of laser fluorescence (DIAGNOdentTM) for in vivo diagnosis of occlusal caries: a systematic review

This systematic review was conducted to assess the accuracy of laser fluorescence (DIAGNOdentTM) for diagnosis of occlusal caries in permanent teeth, using any sort of gold standard. The MEDLINE, LILACS, BBO and Cochrane library databases accessed by BIREME were searched for English, Spanish and Portuguese-language papers published between 1982 and 2003. Four works in English were selected. DIAGNOdentTM was found to be an accurate method for diagnosis of occlusal caries, mainly if employed simultaneously with visual inspection.

Filler morphology of resin-based low-viscosity materials and surface properties after several photoactivation times.

AIM This study aimed to characterize the morphology of filler particles and to analyze the effect of shortened and extended photoactivation times on hardness (VHN) and cross-link density (CLD) of resin-based low-viscosity materials. METHODS Sixteen commercially available materials were tested: four fissure sealants (Alpha Seal, Fluroshield Yellowed, Bioseal and Fluroshield White) and 12 flowable composites (Opallis T, Permaflo T, Opallis A2, Natural Flow A2, Master Flow A2, Permaflo A2, Filtek Z350 A2, Natural Flow O, Master Flow OA2, Opallis OA3.5, Filtek Z350 OA3, Opallis OP) at six curing times (10 s, 20 s, 30 s, 40 s, 50 s and 60 s). Specimens were fabricated (n = 5), analyzed by Scanning Electron Microscopy, by VHN and by CLD. RESULTS Unimodal and multimodal filler particles sizes with spherical and irregular shapes were observed. Unfilled materials were also detected. There were no differences among curing times for either VHN or CLD. Opallis A2 and Opallis OA3.5 showed the highest VHN at all curing times, whereas Master Flow A2 and Master Flow OA2 presented the lowest VHN. Opallis A2 presented the highest CLD at all curing times and Alpha Seal showed the lowest CLD. CONCLUSIONS Filler particle morphology differed among the resin-based low-viscosity materials tested. The shortest photoactivation time tested could yield similar VHN and CLD means to those provided by the most extended photoactivation time.

CLAREAMENTO DENTÁRIO COMO ETAPA PRÉVIA À RESTAURAÇÃO DE DENTES COM ALTERAÇÃO SEVERA DE COR

Introducao: A cor dos elementos dentarios consiste em fator determinante para a harmonia do sorriso, sendo objeto de preocupacao por parte de profissionais e pacientes. Alem da relevância estetica, o clareamento dentario, previo a realizacao do tratamento restaurador, pode orientar a adocao de procedimentos menos invasivos, que contribuam para preservacao da estrutura dentaria. Assim, este relato destaca o papel do clareamento dentario na tomada de decisao do tratamento restaurador. Relato de Caso: Paciente do genero masculino, 30 anos, procurou servico odontologico especializado devido a insatisfacao com o escurecimento dos elementos 11 e 21. Facetas indiretas em cerâmica foram indicadas no planejamento inicial. Previamente a realizacao do tratamento restaurador, foi proposta a realizacao de clareamento dentario dos dentes escurecidos. Apos o sucesso obtido pela associacao das tecnicas de clareamento nao vital em consultorio, e clareamento caseiro, foi tracado novo planejamento, pautando a realizacao de facetas diretas em resina composta. Assim, foram realizadas facetas em resina composta (elementos 11, 12, 21 e 22), instalacao de pinos de fibra de vidro (elementos 11 e 21), alem de ajuste cosmetico (elemento 23), tendo como resultado principal a estetica do sorriso e a satisfacao do paciente. Conclusao: O clareamento dentario, como uma etapa previa ao tratamento restaurador de dentes escurecidos, orientou a definicao do plano de tratamento e contribuiu para adocao de procedimentos menos invasivos. DESCRITORES: Clareamento Dental. Facetas Dentarias. Restauracao Dentaria Permanente.

Impact of adhesive and photoactivation method on sealant integrity and polymer network formation

We evaluated the influence of photoactivation method and hydrophobic resin (HR) application on the marginal and internal adaptation, hardness (KHN), and crosslink density (CLD) of a resin-based fissure sealant. Model fissures were created in bovine enamel fragments (n = 10) and sealed using one of the following protocols: no adhesive system + photoactivation of the sealant using continuous light (CL), no adhesive system + photoactivation of the sealant using the soft-start method (SS), HR + CL, or HR + SS. Marginal and internal gaps and KHN were assessed after storage in water for 24 h. The CLD was indirectly assessed by repeating the KHN measurement after 24 h of immersion in 100% ethanol. There was no difference among the samples with regard to marginal or internal adaptation. The KHN and CLD were similar for samples cured using either photoactivation method. Use of a hydrophobic resin prior to placement of fissure sealants and curing the sealant using the soft-start method may not provide any positive influence on integrity or crosslink density.