Larissa Soares Reis Vilanova

Marginal microleakage of class V resin-based composite restorations bonded with six one-step self-etch systems

This study compared the microleakage of class V restorations bonded with various one-step self-etching adhesives. Seventy class V resin-based composite restorations were prepared on the buccal and lingual surfaces of 35 premolars, by using: Clearfil S3 Bond, G-Bond, iBond, One Coat 7.0, OptiBond All-In-One, or Xeno IV. The Adper Single Bond etch-and-rinse two-step adhesive was employed as a control. Specimens were thermocycled for 500 cycles in separate water baths at 5°C and 55°C and loaded under 40 to 70 N for 50,000 cycles. Marginal microleakage was measured based on the penetration of a tracer agent. Although the control showed no microleakage at the enamel margins, there were no differences between groups (p = 0.06). None of the adhesives avoided microleakage at the dentin margins, and they displayed similar performances (p = 0.76). When both margins were compared, iBond® presented higher microleakage (p < 0.05) at the enamel margins (median, 1.00; Q3-Q1, 1.25-0.00) compared to the dentin margins (median, 0.00; Q3-Q1, 0.25-0.00). The study adhesives showed similar abilities to seal the margins of class V restorations, except for iBond®, which presented lower performance at the enamel margin.

Diagnostic criteria for temporomandibular disorders: self-instruction or formal training and calibration?

BackgroundTo investigate the difference in diagnostic reliability between self-instructed examiners and examiners taught in a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) course and if the reliability of self-instructed examiners improves after the course.MethodsSix examiners were divided into three groups: (1) formal two-day training and calibration course at a DC/TMD training center (Course group), (2) self-teaching through documents and movie (Self group) with three examiners on each and the Self group later participated in the course (Self + course group). Each group examined sixteen subjects, total of 48 volunteers (36 patients with TMD and 12 asymptomatic) and the reliabilities in relation to the diagnoses derived by a Reference Standard Examiner were compared by Cohen’s Kappa coefficient.ResultsThe reliability was good to excellent in all three groups of examiners for all DC/TMD diagnoses, except for Myofascial pain with referral in the Self + course group. The course seemed to improve the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.ConclusionsThis study shows that the diagnostic reliability of formal DC/TMD training and calibration and DC/TMD self-instruction are similar, except for subgroups of Myalgia. Thus, self-instruction seems to be possible to use to diagnose the most common TMDs in general dental practice. The course further improves the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.

Hormonal fluctuations intensify temporomandibular disorder pain without impairing masticatory function.

PURPOSE The influence of hormonal fluctuations on pain and mastication was evaluated in patients with painful temporomandibular disorder (TMD) symptoms. MATERIALS AND METHODS Fifty women were assigned to menstrual cycle and oral contraceptive groups (n = 25). Their TMD was diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders. Pain levels, maximum oclusal force (MOF), and masticatory performance (MP) were measured in all menstrual cycle phases. RESULTS A lower pain level was observed in the ovulatory phase when compared to menstrual and luteal phases (P = .02). No differences were found regarding MOF (P = .20) or MP (P = .94). CONCLUSIONS Hormonal fluctuations intensify pain in women with symptomatic TMD without impairing mastication.

Kinesiographic study of masticatory movements in denture wearers with normal and resorbed denture-bearing areas.

STATEMENT OF PROBLEM An unfavorable denture-bearing area could compromise denture retention and stability, limit mastication, and possibly alter masticatory motion. PURPOSE The purpose of this study was to evaluate the masticatory movements of denture wearers with normal and resorbed denture-bearing areas. MATERIAL AND METHODS Completely edentulous participants who received new complete dentures were selected and divided into 2 groups (n=15) according to the condition of their denture-bearing areas as classified by the Kapur method: a normal group (control) (mean age, 65.9 ± 7.8 years) and a resorbed group (mean age, 70.2 ± 7.6 years). Masticatory motion was recorded and analyzed with a kinesiographic device. The patients masticated peanuts and Optocal. The masticatory movements evaluated were the durations of opening, closing, and occlusion; duration of the masticatory cycle; maximum velocities and angles of opening and closing; total masticatory area; and amplitudes of the masticatory cycle. The data were analyzed by 2-way ANOVA and the Tukey honestly significant difference post hoc test (α=.05). RESULTS The group with a resorbed denture-bearing area had a smaller total masticatory area in the frontal plane and shorter horizontal masticatory amplitude than the group with normal denture-bearing area (P<.05). CONCLUSIONS Denture wearers with resorbed denture-bearing areas showed reduced jaw motion during mastication.

Female hormones fluctuation and chewing movement of patients with disc displacement

PURPOSE: This study aimed to verify the influence of hormonal fluctuations on chewing movement in women with disc displacement (DD). METHODS: Fourteen women with DD taking oral contraceptives (OC); 12 DD-free controls taking OC; 12 normally cycling women with DD; and 14 DD-free normally cycling women were included. The Research Diagnostic Criteria for Temporomandibular Disorders diagnosed DD, and subjects without pain were selected. Chewing movements were recorded using a kinesiograph. Dependent variables were: vertical, lateral, and anterior-posterior amplitudes (mm), opening and closing velocity (mm/s), which was evaluated in 4 phases of 3 menstrual cycles, identified by ovulation test. Data were submitted to Mauchlys sphericity test, Proc Mixed for repeated measures, and Tukey-Kramer test (P ≤ 0.05). RESULTS: Comparisons among menstrual cycle phases showed no differences in vertical (P = 0.25), lateral (P = 0.12), and anterior-posterior amplitudes (P = 0.61); as well as opening (P = 0.57) or closing velocity (P = 0.73). The OC use or presence of DD did not influence the variables (P > 0.05). CONCLUSION: Hormonal fluctuation did not influence chewing mandibular movement of women with DD.

Apexification of an Immature Permanent Incisor with the Use of Calcium Hydroxide: 16-Year Follow-Up of a Case.

Apexification is a process of forming a mineralized apical barrier and had been performed by using calcium hydroxide paste, due to its biological and healing performances in cases of existent trauma. This clinical report aims to report the results of a 16-year follow-up study of an apexification treatment applied to nonvital tooth 22 of a healthy 8-year-old male after a trauma. Clinical inspection of the tooth showed fractures of the incisal edge and mesial angle, absence of coronal mobility, and negative pulp vitality under cold testing. Radiographic analysis of the root revealed incomplete apex formation. The possibility of fracture into the root or luxation injury was rejected, and the diagnosis of pulp necrosis was verified. Apexification by calcium hydroxide and subsequent endodontic treatment were planned. Initial formation of the mineralized apical barrier was observed after 3 months, and the barrier was considered to be completed after 8 months. Clinical, radiographic, and CBCT examinations after 16 years verified the success of the treatment, although the choice of calcium hydroxide for apexification treatment is discussed.

Mastication movements and sleep quality of patients with myofascial pain: occlusal device therapy improvements.

STATEMENT OF PROBLEM Patients with myofascial pain experience impaired mastication, which might also interfere with their sleep quality. PURPOSE The purpose of this study was to evaluate the jaw motion and sleep quality of patients with myofascial pain and the impact of a stabilization device therapy on both parameters. MATERIAL AND METHODS Fifty women diagnosed with myofascial pain by the Research Diagnostic Criteria were enrolled. Pain levels (visual analog scale), jaw movements (kinesiography), and sleep quality (Epworth Sleepiness Scale; Pittsburgh Sleep Quality Index) were evaluated before (control) and after stabilization device use. Range of motion (maximum opening, right and left excursions, and protrusion) and masticatory movements during Optosil mastication (opening, closing, and total cycle time; opening and closing angles; and maximum velocity) also were evaluated. Repeated-measures analysis of variance in a generalized linear mixed models procedure was used for statistical analysis (α=.05). RESULTS At baseline, participants with myofascial pain showed a reduced range of jaw motion and poorer sleep quality. Treatment with a stabilization device reduced pain (P<.001) and increased both mouth opening (P<.001) and anteroposterior movement (P=.01). Also, after treatment, the maximum opening (P<.001) and closing (P=.04) velocities during mastication increased, and improvements in sleep scores for the Pittsburgh Sleep Quality Index (P<.001) and Epworth Sleepiness Scale (P=.04) were found. CONCLUSION Myofascial pain impairs jaw motion and quality of sleep; the reduction of pain after the use of a stabilization device improves the range of motion and sleep parameters.

Is migraine a complicating factor for evidence-based therapy for masticatory myofascial pain? A case-control study.

OBJECTIVE This study aimed to assess the response to conservative treatment of pain in patients diagnosed with masticatory myofascial pain (MMP) with or without migraine. STUDY DESIGN A total of 61 patients were evaluated and divided into 2 groups: Group 1 (G1), patients with MMP (n = 34); Group 2 (G2), patients with MMP and migraine (n = 27). Pain was assessed subjectively by visual analog scale (VAS) and objectively through masticatory muscle palpation at baseline and after 3 treatment visits. Treatment included occlusal appliances, medication, and self-care exercises. RESULTS G2 reported greater discomfort subjectively and objectively at all evaluation visits; however, significant difference between groups was noted objectively only at baseline (P = .0052). Regardless of group, pain levels decreased significantly over time as measured by VAS analyses (G1 P = .0033; G2 P = .0031) and muscle palpation (G1 P < .0001; G2 P < .0001). CONCLUSIONS Evidence-based therapy improved pain scores over time in MMP patients regardless of the presence of migraine.

Reproducibility, Reliability, and Validity of Fuchsin-Based Beads for the Evaluation of Masticatory Performance

PURPOSE Rehabilitation of masticatory function is inherent to prosthodontics; however, despite the various techniques for evaluating oral comminution, the methodological suitability of these has not been completely studied. The aim of this study was to determine the reproducibility, reliability, and validity of a test food based on fuchsin beads for masticatory function assessment. MATERIALS AND METHODS Masticatory performance was evaluated in 20 dentate subjects (mean age, 23.3 years) using two kinds of test foods and methods: fuchsin beads and ultraviolet-visible spectrophotometry, and silicone cubes and multiple sieving as gold standard. Three examiners conducted five masticatory performance trials with each test food. Reproducibility of the results from both test foods was separately assessed using the intraclass correlation coefficient (ICC). Reliability and validity of fuchsin bead data were measured by comparing the average mean of absolute differences and the measurement means, respectively, regarding silicone cube data using the paired Students t-test (α = 0.05). RESULTS Intraexaminer and interexaminer ICC for the fuchsin bead values were 0.65 and 0.76 (p < 0.001), respectively; those for the silicone cubes values were 0.93 and 0.91 (p < 0.001), respectively. Reliability revealed intraexaminer (p < 0.001) and interexaminer (p < 0.05) differences between the average means of absolute differences of each test foods. Validity also showed differences between the measurement means of each test food (p < 0.001). CONCLUSIONS Intra- and interexaminer reproducibility of the test food based on fuchsin beads for evaluation of masticatory performance were good and excellent, respectively; however, the reliability and validity were low, because fuchsin beads do not measure the grinding capacity of masticatory function as silicone cubes do; instead, this test food describes the crushing potential of teeth. Thus, the two kinds of test foods evaluate different properties of masticatory capacity, confirming fushsin beads as a useful tool for this purpose.

Esthetic Rehabilitation of the Smile with No-Prep Porcelain Laminates and Partial Veneers.

Rehabilitation of patients with anterior conoid teeth may present a challenge for the clinician, especially when trying to mimic the nature with composite resins. This clinical report exemplifies how a patient with conoid upper lateral incisors was rehabilitated with minimally invasive adhesive restorations. Following diagnostic wax-up and cosmetic mock-up, no-prep veneers and ceramic fragments (partial veneers) were constructed with feldspathic porcelain. This restorative material presents excellent reproduction of the optical properties of the dental structure, especially at minimal thicknesses. In this paper, the details about the treatment are described. A very pleasing outcome was achieved, confirming that minimally invasive adhesive restorations are an excellent option for situations in which the dental elements are healthy, and can be modified exclusively by adding material and the patient does not want to suffer any wear on the teeth.