Patrícia de Almeida Rodrigues Silva e Souza

Adhesive systems: important aspects related to their composition and clinical use

This literature review article addresses the types and the main components of different etch-and-rinse and self-etch adhesive systems available in the market, and relates them to their function, possible chemical interactions and influence of handling characteristics. Scanning electron microscopy (SEM) images are presented to characterize the interface between adhesives and dentin. Adhesive systems have been recently classified according to their adhesion approaches in etch-and-rinse, self-etch and glass ionomer. The etch-andrinse systems require a specific acid-etch procedure and may be performed in two or three steps. Self-etch systems employ acidic monomers that demineralize and impregnate dental substrates almost at the same time. These systems are separated in one or two steps. Some advantages and deficiencies were noted for etch-and-rinse and self-etch approaches, mainly for the simplified ones due to some chemical associations and interactions. The SeM micrographs illustrate different relationships between adhesive systems and dental structures, particularly dentin. The knowledge of composition, characteristics and mechanisms of adhesion of each adhesive system is of fundamental importance to permit the adoption of ideal bonding strategies under clinical conditions.

A New Weak Chelator in Endodontics: Effects of Different Irrigation Regimens with Etidronate on Root Dentin Microhardness

This study investigated the effect of sodium hypochlorite (NaOCl), ethylenediaminetetraacetic (EDTA), etidronic (HEBP), and citric acid (CA) associated in different irrigation regimens on root dentin microhardness. Forty-five root halves of single-rooted teeth were sectioned into thirds that were embedded in acrylic resin, polished, randomly assigned into 3 groups, and treated as follows: G1: saline solution; G2: 5% NaOCl + 18% HEBP, mixed in equal parts; and G3: 2.5% NaOCl. After measurements, the G3 samples were distributed into subgroups G4, G5, and G6, which were submitted to 17% EDTA, 10% CA and 9% HEBP, respectively. Following the new measurements, these groups received a final flush with 2.5% NaOCl, producing G7, G8, and G9. Microhardness was measured with Knoop indenter under a 25 g load for 15 seconds, before and after treatments. The data were statistically analyzed using paired Students t-test (α<0.05) to compare values before and after treatments and analysis of variance (ANOVA) (α<0.05) to detect any differences among thirds. Except G1, all tested irrigation regimens significantly decreased the microhardness. There were no differences between root thirds before treatments, and all root thirds exhibited equal responses to same treatment. Except saline, all tested irrigation regimens reduced the root dentin microhardness.

Ethanol-Wet Bonding Technique: 18-month Clinical Evaluation

El proposito de este ensayo clinico aleatorizado fue evaluar, durante 18 meses, el exito clinico de las restauraciones realizadas por la tecnica de adhesion humeda en etanol (TAHE) en comparacion con las tecnicas de grabado independiente de tres pasos (GTP) y de autograbado de un paso (AUP). Un solo operador, especializado en odontologia restaurativa, realizo sobre 17 pacientes 93 restauraciones en lesiones cervicales no cariosas (31 para cada grupo). Los diferentes protocolos adhesivos se distribuyeron aleatoriamente en las lesiones cervicales hasta que los tres grupos estuviesen presentes en el mismo paciente y en cantidades iguales. Las restauraciones fueron evaluadas a los 6, 12 y 18 meses, por dos examinadores calibrados y que no participaron del procedimiento restaurador. Las directrices modificadas del Servicio de Salud Publica de Estados Unidos (SSPEU) fueron la base para las evaluaciones de las siguientes variables: retencion (kappa= 1,00), adaptacion y decoloracion marginal (kappa= 0,81). Estas variables fueron analizadas mediante la prueba exacta de Fisher y Kruskal-Wallis, respectivamente. No se observo diferencia significativa entre los grupos despues de 18 meses en las tres variables evaluadas (p >0,05). El analisis intra-grupo hecho por la prueba de Cochran (para la retencion) y la prueba de Wilcoxon (para la adaptacion y decoloracion marginal) revelaron diferencias significativas entre los intervalos de tiempo de la linea de base / 18 meses para la retencion (p= 0,0101) y adaptacion marginal en el grupo AUP (p= 0,0117), y para la decoloracion marginal en los grupos GTP (p= 0,0051) e TAHE (p= 0,0277). El analisis de supervivencia para la retencion, asi como la comparacion del exito clinico de los protocolos adhesivos, fueron realizados con la prueba de log-rank, y no hubo diferencias significativas (p >0,05) entre los grupos. No hubo diferencia en el exito clinico de los tres protocolos adhesivos despues de 18 meses.

Manifestaciones Orales en Pacientes Reumatológicos: una Revisión de los Conocimientos

La cavidad oral a traves de sus estructuras, dientes y mucosas, desempenan diversas funciones organicas. Actuan en el proceso masticatorio, en la percepcion de los sabores, ademas de servir de via respiratoria. La relacion entre alteraciones sistemicas y manifestaciones orales esta bien relatada en la literatura. Observandose en numerosos estudios, palabras claves de morbilidades primariamente bucales, seguidas del diagnostico de trastornos sistemicos. Las enfermedades reumaticas pueden manifestarse con alteraciones de la condicion bucal, ademas de las presentaciones clinicas peculiares a cada morbilidad. Para la realizacion de este trabajo fueron investigados en la literatura estudios que evidencien la presencia de manifestaciones orales en enfermedades reumaticas a traves de la busqueda en las bases de datos Lilacs, PubMed y Bireme, incluidos en el ano 2009-2015. Las evidencias existentes en la literatura nos revelan la importancia de la inclusion de la evaluacion clinica de la boca y sus estructuras anexas, como elemento importante en el diagnostico auxiliar y orientacion para el manejo adecuado de las quejas de estos pacientes.

Comparison of bacterial leakage between Epiphany and AH Plus sealers using single cone and Tagger’s hybrid obturation techniques

Purpose: To evaluate and compare, by means of bacterial infiltration, the quality of sealing obtained by Tagger’s hybrid (TH) and Single Cone (SC) techniques, in association with AH Plus/Gutta-percha (AH) and Epiphany/Resilon (ER). Methods: Palatal roots of 70 maxillary molars were instrumented and divided randomly into six groups: G1, TH/AH; G2, SC/AH; G3, TH/ER; G4, SC/ER; G5, negative control; G6, positive control. The roots were sterilized and monitored for 56 days to detect bacterial leakage using Enterococcus faecalis. The data were subjected to Binomial test (α<0.05) to compare the infiltration among groups and Kruskal-Wallis test (α<0.05) to analyze the infiltration as a function of time. Results: All positive controls leaked within 24h; none of negative controls leaked. There was no influence of time on leakage. Individual comparisons showed that there were no influences of the techniques and filling materials on quality of root canal sealing. Significant difference was found only between G1 and G4 (P=0.0229), the G1 showed a lesser and G2 the higher quantity of infiltration. Conclusions: It could be concluded that none of the groups was able to prevent bacterial leakage and the lowest ability to prevent infiltration was obtained when applied SC/ER to filling the canal.

The importance of early diagnosis and an accurate tumoral evaluation in the treatment of mandibular osteossarcoma

OBJETIVO: O osteossarcoma e uma neoplasia maligna do osso que possui um comportamento clinico agressivo, geralmente diagnosticado em estados tardios da doenca, quando o tumor primario atinge dimensoes significativas. Em muitos casos, tratamento cirurgico agressivo com grandes resseccoes osseas e a necessidade de associacao a radio ou quimioterapia se fazem necessarios para melhor controle de recidivas locais e metastases em tais lesoes. DESCRICAO DO CASO: No presente trabalho os autores relataram um caso de osteossarcoma na regiao de corpo e ramo mandibular esquerdo diagnosticado precocemente e avaliado de forma precisa pela tomografia computadorizada tipo cone beam. CONCLUSAO: O diagnostico precoce do osteossarcoma e uma condicao pouco comum que afeta de forma favoravel tanto o tratamento quanto o prognostico deste tumor. A associacao deste diagnostico precoce com uma avaliacao precisa do envolvimento tumoral foram determinantes na execucao de um tratamento cirurgico conservador e ainda assim com finalidade curativa, com um minimo de sequelas. O espaco pericementario deve ser especialmente observado, pois seu espessamento e muito mais comum em osteossarcomas. Estudos que possibilitem identificar esta lesao de forma mais precoce e precisa devem realizados, a fim de possibilitar uma sobrevida maior com melhor qualidade de vida.