Rosenês Lima dos Santos

Radiographic diagnosis of incipient proximal caries: an ex-vivo study

The aim of this ex vivo study was to compare visual clinical and radiographic examinations to the histological analysis for proximal caries diagnosis in extracted permanent molars and premolars. The relationship between clinical aspects and carious lesions was also evaluated. Eighty-eight proximal surfaces (44 freshly extracted teeth) were longitudinally sectioned with a 370-microm diamond disk, thinned with wet silicon carbide paper and observed with a stereomicroscope at x40 magnification. Sensitivity and specificity were 65.6% and 83.3% for clinical examination and 29.7% and 95.8% for radiographic examination, respectively. Kappa values ranged from 0.64 to 0.91. The white spots corresponded to lesions restricted to enamel, while the dark spots corresponded to lesions that reached the dentinoenamel junction. In most cases, cavitation corresponded to dentin lesions. It may be concluded that interproximal radiographic examination is not a reliable method for detection of incipient proximal carious lesions.

Relação entre dentes mal posicionados e a condição dos tecidos periodontais

OBJECTIVE: To identify malpositioned teeth in patients referred to periodontal treatment in the Brazilian Association of Dentistry, Pernambuco Division and evaluate the association of these irregularities with periodontal health. METHODS: The sample comprised 90 individuals aged 15 to 69 years. First, each participant was examined to identify the types of abnormal tooth positions by means of visual inspection. After that, their periodontal health was assessed according to the following clinical parameters: gingival bleeding on probing, periodontal attachment loss, and probing depth. In bivariate analysis, a chi-square test was used to calculate significance of the associations. RESULTS: Several types of changes in tooth position were detected in the participants, and the most significant were: rotated teeth (86.7%); crowding (52.2%); and mesially tipped molar (48.9%). All participants had periodontal changes associated with these abnormalities: 100% had gingival bleeding; 67.8%, gingival recession; 54.4%, gingival enlargement; and 28.9%, chronic periodontitis. There were significant associations between gingival recession and the variables buccally tipped tooth and excessive proclination of maxillary incisors, and also between chronic periodontitis and mesially tipped molar, crowding, excessive proclination of maxillary and mandibular incisors, and diastema (p<0.05). The need of multidisciplinary treatment was clear in all the cases. CONCLUSIONS: Malpositioned teeth negatively affected the health of periodontal tissues, which draws attention to the importance of a multidisciplinary approach that includes, primarily, periodontal and orthodontic care to improve the oral health of patients.

INFLUÊNCIA DA PRESENÇA DO CÁLCIO EM AGENTES CLAREADORES E SUA RELAÇÃO COM A MICRODUREZA DO ESMALTE DENTAL HUMANO

Objective: This study examined the microhardness of tooth enamel exposed to the bleaching agent hydrogen peroxide 35%, with or without calcium in its composition in order to ascertain whether the addition of this substance influences the change in microhardness. Material and methods: The samples were composed of ten intact human third molars, of which three fragments were obtained, so that each fragment from the same tooth was part of a different group. Group B consisted of ten samples, bleached with hydrogen peroxide 35% containing calcium. Group M consisted of ten samples, bleached with hydrogen peroxide at 35% without calcium, and group C (control) consisted of ten samples immersed in artificial saliva. The microhardness was evaluated before the treatment and after three sessions with an interval of seven days between them. Results: In Group B there was an increase of 5.47% in microhardness, considered significant, assigned to the presence of calcium in the bleaching agent. There was a reduction of 2.59% and 0.64% in groups M and C respectively, both considered nonsignificant. Conclusion: It was concluded that the presence of calcium in the whitening gel increases the microhardness of the bleached enamel, providing a remineralization of this substrate.

Effect of periodontal disease on the bond strength of fiber post cemented with different adhesive systems and resin luting agents

The objective of the present study was to determine the effect periodontal disease on the bond strength of fiberglass posts, different adhesive systems and resin cements. Ninety human maxillary central incisors roots extracted due to periodontal disease or prosthetic reasons were endodontically treated and divided into six experimental groups: NPD-ARC – no periodontal disease/RelyX ARC and Adper Single Bond 2; NPD-PF – no periodontal disease/Panavia F and ED Primer; NPD-U – no periodontal disease/RelyX U100; PD-ARC – periodontal disease/RelyX ARC and Adper Single Bond 2; PD-PF – periodontal disease/Panavia F and ED Primer; and PD-U – periodontal disease/RelyX U100. Specimens were subjected to push-out test and data were analyzed by two-way ANOVA and Tukey’s test (p = 0.05). The periodontal disease groups showed that the Panavia F/ED Primer group presented no significantly higher mean values compared with RelyX U100, and that both presented significantly higher mean values when compared with RelyX ARC/Single Bond 2 group. These results were also observed in roots with no periodontal disease. There were no differences in bond strength mean values of roots related or not to periodontal disease.

INFLUÊNCIA DO POLIMENTO SUPERFICIAL NA RETENÇÃO DE PLACA BACTERIANA EM RESTAURAÇÕES ESTÉTICAS

Objective: The aim of this study was to evaluate the influence of superficial finishing and polishing procedures on bacterial plaque retention of composite resin restorations. Material and Methods: Twenty patients participated in the study presenting forty restored surfaces in various classifications of cavities, cervical edges and types of teeth. The finishing and polishing procedures were performed with polishing discs (TDV), silicone points (Optimize – TDV) and strips polishing (3M). To verify plaque retention was used Index Retention and Extension Plaque in Restoration – IRPR, applied before polishing and after 7 and 14 days. Results: The results showed that, before polishing, most of surfaces presented plaque retention on highest levels of IRPR, and after polishing there was reduction and also absence of plaque retention, demonstrated by the lowest levels of IRPR. Conclusion: It was concluded that the polishing materials and the technique used were effective in reducing bacterial plaque retention over restored surfaces, and that IRPR is an efficient method to demonstrate the plaque retention on esthetic restoration.

Prevalence of Dentinal Defects after Root Canal Preparations in Molars with Reciproc and WaveOne Systems

Objective: To evaluate the prevalence of dentin defects, including partial and complete cracks and fractures, after root canal preparation in molars with Reciproc and WaveOne reciprocating instruments. Material and Methods: Fifty mandibular first and second molars with mature apices were selected to endodontic in vitro instrumentation. Ten teeth were unprepared and served as the control, and the remaining forty teeth were divided into two groups, being twenty corresponding to each reciprocating system. Reciproc and WaveOne systems were used in a reciprocating working motion, under the same conditions, to prepare the two mesial canals. Roots were then sectioned 2, 4 and 6 mm from the apex, and the cut surface was observed under a microscope using 20-fold magnification and checked for the presence of fractures and incomplete cracks. Results: none of the evaluated groups presented fractures, and the control group showed no incomplete cracks. Overall evaluation showed statistical differences between these two groups and the control group (p=0.017) for the prevalence of incomplete cracks, but no significant differences were obtained between Reciproc and WaveOne groups (p>0.05). Reciproc group presented more incomplete cracks on 4-mm sections compared with the control group on the same section (p=0.0326). Conclusion: Root canal preparation with both reciprocating instruments resulted in incomplete cracks, but not fractures. At the level of 4 mm from the apex of the canals, the Reciproc system produced significantly more incomplete cracks. Considering both systems, WaveOne utilization resulted in lesser structural alterations on dentin considering the middle portion of the roots.

Noncarious cervical lesions in occlusion service patients: occlusal aspects and risk factors

Objective: To evaluate the occlusal aspects of patients with and without noncarious cervical injury and identify its risk factors. Method: Through a cross-sectional study, 88 patients of both sexes between 18 and 71 years old were evaluated, in Occlusion services in the cities of Joao Pessoa and Campina Grande. Clinical assessments were performed by a single calibrated examiner to check the occlusal aspects of patients with and without injuries, through descriptive and non-parametric analysis with 5% significance level and 95% of confidence interval. Results: Parafunctional habits were identified at a frequency of 92.0% of the patients. Unilateral chewing was not associated with the presence of lesions. The side disocclusion by the canine was prevalent in the whole sample. Occlusal interference in maximal intercuspal position and in nonworking side were presented as risk factors for the higher number of lesions and their development. Wear facets were common in the premolar groups and the maxillary arch in patients with lesions. Conclusion: Occlusal factors pose risks for the development and greater number of noncarious cervical lesions.