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Objective: the present equivalence two-arm parallel randomized controlled trial aimed to compare survival and marginal bone loss (MBL) of short implants (≤6 mm) and standard implants (≥8.5 mm) associated with sinus floor elevation (SFE). Methods: adult patients with partial edentulism with occlusal stability in the sinus area and intermediate bone height were selected in this double-blind trial (patient and outcome assessment). Patients were randomly allocated into two groups: standard length implants with SFE (control) or short implants (test). Clinical and radiographic assessments were made at the time of implant placement, 6 months, and annually thereafter up to 2 years after loading. The inter-examiner agreement was analyzed using intraclass correlation coefficient (ICC). One-way ANOVA, Kaplan-Meier, and Log-rank tests were used to compare implant survival (primary outcome) and MBL (secondary outcome) (P

Contains fulltext : 290735.pdf (Publisher’s version ) (Closed access) Objective To systematically review the literature and assess the effectiveness of perioperative systemic and nonsystemic therapies in reducing edema after orthognathic surgery. Study Design Four databases (PubMed, Web of Science, Bireme, and Scopus) were searched. Only randomized clinical trials were included and assessed using the RoB 2.0 software (Cochrane Collaboration, London, UK). Studies were grouped into time of assessment and systemic/nonsystemic therapy. Results Eighteen studies were included in this review (8 in the meta-analysis, n = 349). The qualitative assessment of systemic (enzyme therapy, dexamethasone, betamethasone, and Venoplant) and nonsystemic therapies (thermotherapy and K-Taping) appear to reduce edema. Manual lymphatic drainage (MLD) after 72 hours (CI: -1.03 to 2.31; P = .45), and 30 days (CI: -1.53 to 0.49; P = .49), and laser after 24 hours (CI: -1.36 to 1.48; P = .93), 72 hours (CI: -4.81 to 2.92; P = .63), 30 days (CI: -3.44 to 0.99; P = .28), and 90 days (CI: -1.83 to 0.96; P = .54) showed no significance. Thermotherapy reduced edema after 48 hours (CI: -48.47 to -13.31; P = .0006) and 30 days (CI: -14.73 to -1.98; P = .01). Conclusion The Grading of Recommendations, Assessment, Development and Evaluations tool showed moderate evidence for thermotherapy (significant reduction of edema), whereas the MLD and laser results were rated as high certainty of evidence (no reduction of edema). 01 februari 2023

Resumo O objetivo deste ensaio clínico randomizado foi comparar a prevalência e a intensidade da dor pós-operatória em casos de retratamento endodôntico, utilizando instrumentos manuais ou reciprocantes (automatizados). O tempo necessário para desobturação e reinstrumentação do canal radicular também foi avaliado. Quarenta e oito indivíduos possuindo um dente unirradicular tratado endodonticamente e portador de periodontite apical assintomática foram incluídos no estudo. Os pacientes foram aleatoriamente distribuídos em dois grupos (n=24/grupo): retratamento com instrumentos manuais de aço inoxidável ou um sistema reciprocante de níquel-titânio (Reciproc; VDW, Munique, Alemanha). A reintervenção endodôntica foi realizada em duas consultas, sendo aplicada medicação intracanal à base de hidróxido de cálcio por 14 dias, antes da obturação. O tempo clínico gasto com os protocolos de desobturação e reinstrumentação do canal radicular foi registrado com um cronômetro digital. Após cada visita, a intensidade da dor pós-operatória foi avaliada em 12, 24, 48 horas e 7 dias por meio da escala de estimativa numérica (Numerical Rating Scale - NRS). Além do registro da dor, os pacientes foram questionados quanto ao uso de analgésicos. Os dados obtidos foram analisados por testes Qui-quadrado e Mann-Whitney (α=0.05). Não foi detectada diferença significativa entre os grupos quanto à prevalência e intensidade da dor ou uso de analgésicos em nenhum dos períodos avaliados. O tempo clínico foi significativamente menor no grupo reciprocante (18 versus 41 minutos). Pode-se concluir que os instrumentos manuais e reciprocantes foram equivalentes quanto à prevalência e intensidade de dor pós-operatória e uso de analgésicos, mas a desobturação e reinstrumentação do canal radicular foram duas vezes mais rápidas com o sistema reciprocante.

To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study.A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis.Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters.The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding).The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.

To estimate the prevalence of spin and completeness of reporting of systematic reviews with metanalysis (SRMAs) in implant dentistry.Inclusion criteria were SRMAs of randomized clinical trials of implant dentistry on survival, success, or failure rates in humans, with no language restriction. Three databases were searched from inception to May 2021. Main outcomes were prevalence of spin (primary outcome) and completeness of reporting (secondary outcome) in abstracts and full texts.We identified 2481 SRMAs and 45 unique manuscripts were included. There was a low presence of spin in the abstracts and full text, except for adverse events, in which 51.1% (in the abstract) failed to mention any adverse event for summarized interventions. There was an adequate report of SRMAs in the full text except for prospective register (33.3% not reported). However, there was an incomplete report for most items in the abstract considering PRISMA-A checklist.In general, the included SRMAs presented a (a) low prevalence of spin (except for adverse events in the abstract); (b) adequate completeness of reporting in the full text (except for prospective register); and (c) incomplete report for most items in the abstracts.

To investigate the prevalence of tooth wear and associated factors in adults from the 1982 Pelotas Birth Cohort.A subsample of the 5,914 individuals from the 1982 Pelotas Birth Cohort was randomly selected to be interviewed and clinically examined at the age of 31. Tooth wear was evaluated using a simplified version of the Tooth Wear Index (TWI), considering the absence or presence of tooth wear in dentin of first molars and anterior teeth (incisors and canines). Independent variables were socioeconomic, demographic, unhealthy behavior, and mental health. Crude and adjusted Poisson regression models were employed. A significant level of P ≤ 0.05 was adopted.A total of 537 individuals were evaluated. A tooth wear prevalence of 61.6% was observed. Females presented a statistically significant lower tooth wear in dentin prevalence ratio (PR) compared to males in the adjusted analysis (PR 0.76; 95% CI: 0.67-0.86). Acid beverage consumption (PR 1.22; 95% CI: 1.01-1.49) and consumption of alcoholic beverages (PR 1.19; 95% CI: 1.04-1.35) were positively associated with tooth wear.Almost 2/3 of the surveyed individuals presented tooth wear in dentin. Being a male, higher consumption of alcohol and acidic beverages were factors associated with tooth wear.There was a high prevalence of tooth wear in dentin in the adult population. Data has also shown the etiological complexity of tooth wear, reinforcing the importance of an early diagnosis and the establishment of preventive measures to decrease the potentially hazardous effect of tooth wear over time.

Objectives: To evaluate longevity of metal-ceramic single crowns cemented using a self-adhesive resin cement in a prospective clinical analytical study. Methods: A total of 152 teeth received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. Next, 93% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analysed considering the loss of crown retention (crown debonding) as the primary outcome. In addition, post debonding, root fracture and tooth loss occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression, with 95% confidence interval was applied for the statistical analysis. Results: Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (93%), with 8 crown debondings occurring after the evaluation period. For secondary outcomes, 9 root fractures, 4 post debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters.Conclusion: The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 93% after an average follow-up of 62 months. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). Clinical Significance: The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns.

In this study, we describe a method for reaching a target population (i.e., dentists practicing in Brazil) to engage in survey research using traditional e-mail invites and recruitment campaigns created on Instagram. This study addresses methodological aspects and compares respondents reached by different methods. A pre-tested questionnaire was used and participants were recruited for 10 days via a source list of email addresses and two discrete Instagram organic open campaigns. A total of 3,122 responses were collected: 509 participants were recruited by email (2.1% response rate) and 2,613 by the two Instagram campaigns (20.7% and 11.7% conversion rates), respectively. Response/min collection rates in the first 24 h ranged between 0.23 (email) and 1.09 (first campaign). In total, 98.8% of all responses were received in the first 48 h for the different recruitment strategies. There were significant differences for all demographic variables (p< 0.001) between email and Instagram respondents, except for sex (p=0.37). Instagram respondents were slightly older, had more professional experience (years in practice), and a higher graduate education level than email respondents. Moreover, most email and Instagram respondents worked in the public sector and private practice, respectively. Although both strategies could collect responses from all Brazilian regions, email responses were slightly better distributed across the five territorial areas compared to Instagram. This study provides evidence that survey recruitment of a diverse, large population sample using Instagram is feasible. However, combination of email and Instagram recruitment led to a more diverse population and improved response rates. Resumo Neste estudo, descrevemos um método para atingir uma população-alvo (dentistas atuando no Brasil) para se engajar em pesquisa do tipo enquete (survey) utilizando convites tradicionais por e-mail e campanhas de recrutamento criadas no Instagram. Este estudo aborda aspectos metodológicos e compara as pessoas entrevistadas alcançadas por diferentes métodos. Foi utilizado um questionário pré-testado e os(as) participantes foram recrutados(as) por 10 dias por meio de uma lista de endereços de e-mail e duas campanhas abertas orgânicas independentes no Instagram. Foram coletadas 3122 respostas: 509 participantes foram recrutados(as) por e-mail (taxa de resposta 2,1%) e 2613 pelas duas campanhas do Instagram (taxas de conversão 20,7% e 11,7%), respectivamente. As taxas de coleta de resposta/min nas primeiras 24h variaram entre 0,23 (e-mail) e 1,09 (primeira campanha). No total, 98,8% das respostas foram recebidas nas primeiras 48h para as diferentes estratégias de recrutamento. Houve diferenças significativas para todas as variáveis demográficas (p

Contains fulltext : 288292.pdf (Publisher’s version ) (Open Access) OBJECTIVE: This study aimed to investigate the wear behaviour of direct composite restorations after 5 years and associated patient factors. METHODS: 38 patients (6 females, 32 males; 35.2 ± 7.6y) from the Radboud Tooth Wear Project with generalized moderate to severe tooth wear were treated with direct composite restorations on all teeth. Ethical approval was sought and granted before the study was undertaken. Intraoral 3D scans were recorded at 1 month (baseline) and 5 years (recall) after treatment. The amount of height loss was measured at six index teeth (first molars and upper central incisors). Patient factors (age, vertical dimension of occlusion increase, bite force, aetiology score, jaw position and bearing/ non-bearing cusps) were included in the analysis. Multilevel multiple regression with bootstrapping was used to analyse the influence of these factors on wear behaviour of restorations. Observer reliability was tested by paired t-tests and Band-Altman plots (p

To estimate the prevalence of spin and completeness of reporting of systematic reviews with metanalysis (SRMAs) in restorative dentistry.Inclusion criteria were SRMAs of randomized clinical trials of restorative dentistry on survival, success, or failure rates of treatment in humans, with no language or year restriction. SRMAs performed with non-RCTs were excluded. PubMed/MEDLINE, Web of Science, Scopus, Embase, and Cochrane Collaboration Library were searched from inception to April 2022. Outcomes were the prevalence of spin (primary outcome) and completeness of reporting (secondary outcome) in the abstract and full text. Data were reported through means and standard deviations or absolute and relative frequencies. Spin in each item was considered low when occurring in less than 25% of the papers, moderate (25 to 75%), or high (more than 75%).We identified 7029 studies and 49 unique manuscripts were included. There was a moderate presence of spin in the abstracts and low in full texts. In the abstracts, 65.9% did not report adverse events; while in the abstract and full text, more than 16% reported a conclusion containing recommendations for clinical practice not supported by the findings. Regarding completeness of reporting, there was poor reporting for most items in the abstract while there was an adequate report in full texts, except for register name and registration number (not reported in 32.7%).Abstract of SRMAs in restorative dentistry should be better reported. Spin and poor reporting were more frequent in the abstracts, which misleads readers and could lead to inadequate clinical recommendations.Spin and incomplete reporting are a threat to evidence-based practice, especially in systematic reviews. Therefore, care providers, researchers, and other stakeholders should be aware of the possibility of spin in systematic reviews and other sources to prevent misinterpretation, which could lead to inadequate decisions and treatments.

The emergence of SARS-CoV-2 in the end of 2019, an aetiologic agent responsible for the 1SARS plunged the world into an unprecedented sanitary crisis. Papers on COVID-19 have been fast-tracked since then.2–5 Accelerated time from submission to publication6–8 and qualitative changes in peer review,9 associated with empirical evidence that duplicate and implausible clinical trials have been carried out during the pandemic,10–12 could perhaps imply lower quality of peer review in COVID-19 research. Accumulating empirical evidence has also been indicating the pandemic era output to be less reliable than its prepandemic counterpart.2 10–14 A systematic review to evaluate the methodological quality of COVID-19 peer-reviewed clinical studies compared with historical controls found methodological quality scores to be lower in COVID-19 articles across all study designs.12 Meanwhile, data sharing practices remained largely unchanged during the first year of the pandemic.13 14 With no mandates of data sharing in place for COVID-19 studies, the reproducibility of these data on COVID-19 is yet to be independently verified as well.2 However, more efficiency in scientific publication did manifest in accelerated publication,6–8 journals tearing down their paywalls for their COVID-19 output,14 an increased usage of life and medical sciences preprint servers to increase speed and transparency,15 not to mention the intense international collaboration that resulted in the development of multiple high-efficacy vaccines within the first year of the pandemic.16 On the other hand, some pratices that reduce the reliability of clinical trials may have gained some traction during 2020, such as executing underpowered studies with small samples, multiplicity of trials testing ideas with low prior probability of being true, forgoing blinding to test interventions10 11 14 17–20 and incomplete reporting of findings, which was already an issue before the pandemic.12 21 To …

OBJECTIVE: This study aimed to analyze the reporting and conduct characteristics of systematic reviews (SRs) published in dentistry by Brazilian corresponding authors and compare reporting characteristics of Brazilian SRs with the rest of the world. METHODS: A search in PubMed was performed to identify SRs published in dentistry in 2017 assessing different aspects of oral heath irrespective of the design of included studies. From this dataset, a subgroup analysis was performed considering only SRs published by Brazilian corresponding authors. Study screening was performed by two researchers independently, while for data extraction, one of three reviewers extracted details related to reporting and conduct of SRs. The completeness of reporting of 24 characteristics, included in the PRISMA Statement of the SRs classified as treatment/therapeutic, was evaluated comparing Brazilian SR to SRs from all other countries. RESULTS: We included 117 SRs with Brazilian corresponding authors. The majority focused on dental treatments (39.3%), with oral surgery (n=19, 16.2%) as the most commonly published. Included SRs presented varying reporting/conduct characteristics. Items such as use of reporting guidelines and screening method used were well reported. However, most SRs did not assess the risk of publication bias and did not use the GRADE assessment. Four (of 24) reporting characteristics of Brazilian SRs compared to SRs from the rest of world were reported statistically significantly more frequently: mention of a SR protocol, trial registry searched, screening method reported, and assessment of risk of bias/quality of studies. CONCLUSION: Reporting and conduct characteristics of Brazilian SRs are highly variable.

OBJECTIVE This article aims to discuss key aspects of systematic reviews (SR) focusing on the improvement of the conduct and reporting. METHODS Important aspects of SRs, such as prospective registration of the review protocol, basic structure, inclusion criteria, use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, confidence in the results and future directions are discussed. To determine relevant aspects, a search was conducted without date limitations in PubMed (October 15th, 2017) to identify SRs written in English evaluating clinical performance of direct composite resin restoration in permanent posterior teeth or comparing direct composite resin with other material/techniques. The quality of SRs included was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 tool. RESULTS Fifteen SRs were included. The overall confidence in the results of SRs was classified as critically low. Some aspects should be highlighted: SRs of in vitro studies are an important tool in restorative dentistry, and initiatives such as the PRISMA Statement and PROSPERO should be considered a standard code of practice. CONCLUSIONS The compliance with and awareness of the discussed aspects may be a significant feature of the improvement of SR quality in the dentistry. CLINICAL SIGNIFICANCE Initiatives such as the PRISMA Statement and PROSPERO should be taken in account by systematic reviewers in dentistry to improve the conduct and reporting of SRs, and to make their reviews are more clinically helpful.

O presente estudo avaliou o comprimento e a proporção dentária em dentes anterossuperiores de pacientes com e sem sorriso gengival. Material e métodos: Selecionaram-se 38 indivíduos para cada um dos grupos: caso (sorriso gengival) e controle. Modelos de gesso foram obtidos mediante moldagem das arcadas, para então serem realizadas as mensurações. Também se submeteram os pacientes a um breve questionário. Resultados: Os dados foram tabulados e analisados por meio de análise de variância sob um nível de significância de 5%. Em ambos os grupos, a maioria foram mulheres (68,4%), brancos (98,7%), com idade variando de 18 a 28 anos. A maior altura encontrada foi para o dente 21 do grupo controle (9,88 mm), e a maior proporção para o dente 11 do grupo caso (87,43%). Analisando a classe dentária, somente a proporção dos incisivos centrais dos casos foram estatisticamente diferentes (p = 0,041), com uma proporção maior. Conclusão: Indivíduos com sorriso gengival possuem proporção dentária maior do que aqueles que não apresentam, entretanto nem todos os dentes podem ter tal diferença.

This prospective study assessed the effect of post type used to restore endodontically treated teeth in the onset, progression, and remission of periapical lesions. One hundred and forty teeth (92 patients) were endodontically treated and received a glass fiber post or a cast metal post and a final restoration at a University Clinic by undergraduate students. All patients were followed up for a mean period of 5.1 ± 2.2 years. Periapical Index (PAI) was used for endodontic assessment. Two calibrated and blind examiners assessed the radiographs. The longevity of the endodontic treatment was analyzed using Kaplan–Meier statistics. Of the included teeth, 67.1% received glass fiber posts while 32.9% received cast metal posts. There were 4 endodontic failures, two glass fiber posts with a PAI = 3 in the baseline and PAI = 4 in the last follow-up, and one PAI = 4 in baseline and last follow-up. One cast metal post-failure was PAI = 4 in the baseline and the last follow-up. After 9.4 years, the overall success rate of the endodontic treatment was 97.1% (p = 0.7). The tested posts presented similar endodontic healing. Precautions taken during endodontic therapy, post cementation, and final restoration are more likely to be responsible for the success of endodontic treatment rather than a specific type of post. Clinical relevance The type of post is not related to the success of the endodontic treatment.

Background Even though considered as studies with high methodological power, many RCTs in paediatric dentistry do not have essential quality items in their design, development, and report, making results' reliability questionable, replication challenging to conduct, wasting time, money, and efforts, and even exposing the participants to research for no benefit. Aim We addressed the main topics related to transparency in clinical research, with an emphasis in paediatric dentistry. Design We searched for all controlled clinical trials published from January 2019 up to July 2020 in the three paediatric dentistry journals with high journal Impact Factor, indexed on Medline. These papers were assessed for transparency according to Open Science practices and regarding reporting accuracy using some items required by CONSORT. Results 53.6% of the studies declared registration, 75% had sample size calculation, 98.2% reported randomisation, and from those, 65.4% explained the randomisation method. Besides that, no study shared their data, and 6.8% were published in open access format. Conclusions Unfortunately, a large proportion of RCTs in paediatric dental research show a lack of transparency and reproducibility.

Objective: The aim of this systematic review was to compare the clinical failure rate of orthodontic miniscrews in maxilla and mandible. Material and Methods: Randomized controlled trials of patients in orthodontic treatment, which required miniscrews for orthodontic intervention reporting the failure rate of miniscrews in the maxilla and mandible were searched in Pubmed database. Two authors independently reviewed all identified titles and abstracts for eligibility. Comparison between failures in maxilla and mandible were estimated using pairwise meta-analysis to calculate the relative risk (RR) of failure and the 95% confidence intervals using a random-effect model. The reports of randomized trials were assessed for bias using the Cochrane risk of bias tool. Results: Four studies fulfilled the eligibility criteria. 299 patients with a total of 628 miniscrews installed were included in the analysis. The analysis showed a 0.55 RR (95% CI 0.23–1.29) and I2 = 85%. All studies had an unclear risk of bias regarding to the two following items: allocation concealment, blinding of participants and personnel. All studies had a low risk of bias with regard to incomplete outcome data and selective reporting. The results did not demonstrate statistical difference between risk of failure of miniscrew between maxilla and mandible. Conclusion: The results of the meta-analysis showed that miniscrews installed in maxilla presents reduced risk of failure. A tendency of higher number of failures in mandible was also demonstrated. However, results should be interpreted with caution because of the very low quality of included studies and the differences among methodologies. KeywordsMeta-analysis; Orthodontic anchorage procedures; Review.

Bone loss in the edentulous posterior maxilla complicates dental implant placement. In spite of the evidence available, there is continued uncertainty about the benefit of short implants for different outcomes.The purpose of this review was to evaluate the existing evidence for short and standard implants in association with sinus floor elevation regarding implant survival, marginal bone loss, and complications by using an umbrella review of the evidence across meta-analysis of interventional studies.Medline, Scopus, and Cochrane Library were searched to identify systematic reviews and meta-analyses comparing short implants and standard implants associated with sinus floor elevation. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. Outcomes were categorized and tabulated to assess effectiveness. Qualitative data were analyzed using thematic synthesis. The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.From 2011 studies, 7 systematic reviews (66 studies) were included as per the eligibility criteria. There was no statistically significant difference between groups for implant survival (risk ratio=1.08; P=.79), and the qualitative analysis did not show differences for prosthetic outcomes. Standard implants were associated with fewer prosthetic complications in the quantitative analysis (risk ratio=3.27; P.01), but no difference was found between the treatments in the qualitative analysis. Short implants showed reduced marginal bone loss (0.98 ±0.12 mm; mean difference=-0.22; P.01) and better biologic outcomes (risk ratio=0.16; P.01). Patient satisfaction was similar for both groups, whereas costs and time for the procedure favored short implants. The quality of the evidence was graded as "critically low" (57.1% of the reviews) and "low." There was a high certainty of evidence for implant survival, whereas marginal bone loss and complications had moderate certainty.Short implants had a better or equal performance compared with standard implants for all outcomes assessed. However, assumptions were based on reviews with low or critically low quality of the evidence, suggesting the development of high-quality systematic reviews in this field.

Objective This study aimed to assess the survival and success of glass fiber posts compared to cast metal posts in teeth without ferrule. Material and Methods An equivalency, prospective, double-blind (patient and outcome evaluator) randomized controlled trial (RCT) with parallel groups was designed to compare the clinical performance of cast metal and glass fiber posts cemented in endodontically treated teeth without ferrule (NCT01461239). Teeth were randomly allocated to the glass fiber or cast-metal post groups. All teeth were restored with single metal-ceramic crowns. Kaplan-Meier analysis with the log-rank test was used to test the success and survival between glass fiber and cast metal posts considering a cut-off value of P = 0.05. The annual failure rates were calculated considering the survival data for all restorations and separated by type of post after five years. Results A hundred and nineteen patients and 183 posts (72 cast metal posts and 111 glass fiber posts) were analyzed. The median follow-up was 62 months (IQR 37–81). The log-rank test for success (P = 0.26) and survival (P = 0.63) analyses did not present statistically significant differences. The AFR of both posts after 5 years was 1.5%. Considering the posts separately and after 5 years, cast metal posts presented AFR of 1.2% and glass fiber posts AFR of 1.7%. Most failures were in posterior teeth (16/23), 10 failures were classified as root fractures and 5 as post debonding. The follow-up rate was 95.3%. Conclusions Glass fiber and cast metal posts showed good and similar clinical performance. Clinical Significance Results of this randomized controlled trial can help dentists to answer how the best technique to rehabilitate endodontically treated teeth with no remaining coronal wall.

The authors aimed to evaluate the effectiveness of glycine air-polishing compared to curette debridement on the treatment of peri-implant diseases. PRISMA guidelines for systematic reviews were followed. Clinical trials of patients diagnosed with peri-implant mucositis or peri-implantitis treated with glycine air-polishing or curette debridement were selected. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE via PubMed, EMBASE, Scopus, Web of Science and BVS) were searched until july 2021. The risk of bias was assessed using RoB 2 and ROBINS-I tools and the certainty of the evidence using GRADE. Bleeding on probing (BOP), probing depth (PD) and plaque index (PI) were assessed. Subgroup analyses were performed considering the follow-up period for peri-implant mucositis. Seven studies were included and meta-analyses were performed with three randomized clinical trials (RCTs), all presenting a low risk of bias. Low quality of evidence was achieved. Both treatments presented similar global results on the BOP and PI peri-implant mucositis analyses. Glycine air-polishing showed better results (p=0.04; I2=90%) on PD peri-implant mucositis meta-analysis. Data was insufficient to perform any analysis considering peri-implantitis. Although there was modest effect of glycine air polishing on probing depth compared to manual curatagge, there is insufficient evidence to suggest either glycine air-polishing or curette debridement to reduce signs of peri-implant diseases (CRD42019128599).

Objective: The aim of the study was assess the knowledge and attitudes of students and dentists about the use and cementation of intra-radicular posts. Material and Methods: This cross-sectional study interviewed 150 students and 150 dentists in the city of XXXXXXXXX (Brazil). A questionnaire containing questions regarding restorative choice in teeth with large coronal destruction, level of confidence for the use of post and resin cement, function of intra-radicular posts and social-demographic characteristics was applied. Data were analysed using descriptive analysis and associations were tested through logistic regression using 95% confidence intervals. Results: The analysis showed that students presented an odd to choose prefabricated posts 127% greater than the dentists for anterior teeth, 105% greater to choose self-adhesive resin cement and 46% greater to choose conventional resin cement. Considering posterior teeth, students presented an odd to choose prefabricated posts 40% smaller than the dentists and an odd 51% greater to choose conventional resin cement. Conclusion: The formation level (students or dentists) was directly related to clinical choices of the interviewed. The use of prefabricated posts seems to be related to the location of the tooth in the arch, with pre-fabricated posts being more indicated for anterior teeth. Use of pre-fabricated posts in teeth with large coronal destruction is accepted in the literature. However, dentists are still not confident to use of pre-fabricated fiber posts especially in posterior teeth with large coronal destruction.KeywordsResin cements; Post and core technique; Health knowledge, attitudes, practice.

PURPOSE This randomized clinical trial assessed how surface roughness (Ra) in resilient liners was affected by soft tissue health conditions and time-related aspects in patients with complete dentures. METHODS Specimens of acrylic resin (control) and denture liners (silicone-based or acrylic resin-based) were inserted into the dentures of patients with and without denture stomatitis (n = 30). Ra was evaluated before denture insertion and after 7, 14, and 21 days of prosthesis wearing. Data were analyzed using three-way analysis of variance and Student-Newman-Keuls test. RESULTS Patients with stomatitis showed a higher Ra (P < .001), while all liners presented rougher surfaces after 14 days of clinical service, irrespective of the soft tissue health condition. CONCLUSION Ra of the tested denture liners was increased in patients with denture stomatitis. It is presumed that a longer wearing period will result in rougher surfaces.

This randomized clinical trial evaluated the influence of the type of intraradicular posts (glass fiber post or cast metal post) in the success of endodontic treatment in teeth that received single metal-ceramic restoration. The sample consisted of adult patients, who presented for the first time seeking routine dental care at the dental school over a period of 5 years. Seventy-six out of ninety-six teeth that received endodontic treatment and intraradicular post were analyzed, randomly distributed in two groups – glass fiber post (n=38), and cast metal post (n=38). The quality of the endodontic treatment was radiographically evaluated, and the apical status was assessed using the periapical index (PAI). Statistical Analyses were performed to a significance level of 5%. Descriptive analyses were used to characterize the teeth and survival curves were created using the Kaplan–Meier method. The success rate of endodontic treatment was 90.8% (n=69) including glass fiber post and cast post. When appropriate endodontic treatment was performed is possible to conclude that the success of endodontic treated teeth that received posts was not related to the post type. Este ensayo clínico aleatorizado evaluó la influencia del tipo de postes intrarradiculares (postes de fibra de vidrio o postes de metal fundido) en el éxito del tratamiento de endodoncia en los dientes que recibieron restauración de metal-cerámica simple. La muestra estuvo conformada por pacientes adultos, quienes acudieron por primera vez buscando atención odontológica de rutina en la facultad de odontología durante un período de 5 años. Se analizaron setenta y seis de los noventa y seis dientes que recibieron tratamiento endodóntico y poste intrarradicular, que consistieron en dos grupos: poste de fibra de vidrio (n = 38) y poste de yeso (n = 38). La calidad del tratamiento endodóntico se evaluó radiográficamente y el estado apical se evaluó mediante el índice periapical (PAI). Los análisis estadísticos se realizaron a un nivel de significancia del 5%. Se utilizaron análisis descriptivos para caracterizar los dientes y se crearon curvas de supervivencia mediante el método de Kaplan-Meier. La tasa de éxito del tratamiento endodóntico fue del 90,8% (n = 69), incluidos los postes de fibra de vidrio y los postes de yeso. Cuando se realizó el tratamiento de endodoncia adecuado, es posible concluir que el éxito de los dientes tratados con endodoncia que recibieron postes no estuvo relacionado con el tipo de postes. Este ensaio clínico randomizado avaliou a influência do tipo de pino intrarradicular (pino de fibra de vidro ou pino de metálico-fundido) no sucesso do tratamento endodôntico em dentes que receberam restauração metalocerâmica. A amostra foi composta por pacientes adultos, que se apresentaram pela primeira vez em busca de atendimento odontológico de rotina na faculdade de odontologia durante um período de 5 anos. Foram analisados ​​setenta e seis dos noventa e seis dentes que receberam tratamento endodôntico e pino intrarradicular, aleatoriamente distribuídos em dois grupos - pino de fibra de vidro (n = 38) e pino metálico-fundido (n = 38). A qualidade do tratamento endodôntico foi avaliada radiograficamente e o estado apical foi avaliado pelo índice periapical (PAI). As análises estatísticas foram realizadas a um nível de significância de 5%. Análises descritivas foram utilizadas para caracterizar os dentes e as curvas de sobrevivência foram criadas usando o método de Kaplan-Meier. A taxa de sucesso do tratamento endodôntico foi de 90,8% (n = 69) incluindo pino de fibra de vidro e pino metálico-fundido. Concluindo, quando foi realizado o tratamento endodôntico adequado, o sucesso da terapia endodôntica não teve relação com tipo de pino intraradicular.

Introduction Numerous factors may influence the survival/success of post-retained restorations of endodontically treated teeth (ETT). The aim of this review was to assess the influence of the number of remaining coronal walls, the use or disuse of posts, and their type on the clinical performance of these restorations. Methods Randomized controlled trials and controlled clinical trials for ETT restored with a combination of post/crown or no post/crown were searched for in MEDLINE, Embase, and the Cochrane Library. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and reports of randomized trials were assessed for bias using the Cochrane risk of bias tool. Results Nine articles were identified as meeting the inclusion criteria. Teeth without ferrule presented the highest values of variation of success/survival (0%–97%), whereas teeth with remaining coronal walls (1, 2, 3, or 4 walls with ferrule) presented lower variation. The use of posts with a high elastic modulus success/survival ranged between 71.8% and 100%, whereas posts with a low elastic modulus ranged between 28.5% and 100%. The survival of crowns without posts varied between 0% and 100%. The poor performance of posts with a low elastic modulus and without posts was associated with the absence of ferrule and the preservation of only 1 coronal wall. Conclusions The restoration of ETT should focus on the maintenance of the coronal structure. Until more studies with longer follow-up periods are available, posts with a high elastic modulus appear to present with better performance when restoring ETT with no ferrule.

Contains fulltext : 169646.pdf (Publisher’s version ) (Closed access) OBJECTIVES: Composite resin restorations present high survival rates and when a failure occurs repair is often possible. The aim of this study was to assess the effect of various repair techniques on indirect restorations. METHODS: LAVA Ultimate (3M), and Clearfil Estenia blocks (Kuraray) were repaired with our without surface roughness treatments, silane application and artificial ageing. Micro-shear bond stress tests were performed, while cohesive strength served as positive control. ANOVA was used for cohesive strength and effect of ageing, and linear mixed models to evaluate the effect of treatment variables on repair strength. RESULTS: Both materials reacted differently on surface treatments. Untreated (no treatment, no silane) repair strength was 16.3+/-6.3MPa for LAVA Ultimate and 19.0+/-4.3MPa for Estenia. Thermal cycling resulted in a 14-58% reduction of cohesive strength. Without cycling, all treatments resulted in a significant increase of bond strength in LAVA Ultimate (p

The use of reporting guidelines has an important role in the development of health research, improving the quality and precision of the publications. This study evaluated how dental journals use reporting guidelines. All editors of dental journals registered on the 2013 Journal Citation Reports list (n=81) were invited to participate. The data were collected by a self-reported web-based questionnaire. Information about the profile of journal/editor and on the use of reporting guidelines by journals was gathered. Information/recommendations about the use of reporting guidelines were collected from the websites of all journals. Data were descriptively analyzed and frequencies were summarized. Thirty-four (42%) editors completed the questionnaire. Most journals are members of Committee on Publication Ethics (64.7%) and/or follow the International Committee of Medical Journal Editors recommendations (20.6%), while 26.5% are not members of any editorial group. Most editors are unfamiliar with the EQUATOR Network (55.9%), do not work full time (85.3%) and 88.2% have some income/payment. Most of them received educational training for this position (55.9%). The CONSORT Statement was endorsed by 61.8% of journals. Information from websites showed that 44.4% journals do not recommend any reporting guideline, 51.9% mention CONSORT Statement in the website and 28.4% only recommend the use of CONSORT Statement. There is clearly room for improving the use of reporting guidelines in dental journals. Broadening the understanding and the endorsement/adherence/implementation of reporting guidelines by journals may promote quality and transparence of published dental research. Resumo O uso de guias de reporte tem um papel importante no desenvolvimento das pesquisas na saúde, melhorando a qualidade e a precisão das publicações. Esse estudo avaliou como periódicos de odontologia usam os guias de reporte. Todos editores de periódicos de odontologia registrados na lista do 2013 Journal of Citation Reports (n=81) foram convidados a participar. Dados foram coletados através de um questionário online autoaplicável. Informações sobre o perfil do periódico/editor e do uso de guias de reporte pelos periódicos foram coletados. Informações/recomendações sobre o uso de guias de reporte foram também coletados dos sites de todos os periódicos. Dados foram analisados descritivamente e frequências foram sumarizadas. Trinta e quatro (42%) editores completaram o questionário. Maioria dos periódicos é membro do Committee on Publication Ethics (64,7%) e/ou seguem as recomendações do International Committee of Medical Journal Editors (20,6%), enquanto 26,5% dos periódicos não são membros de nenhum grupo editorial. A maioria dos editores não é familiar com o EQUATOR Network (55,9%), não trabalha em tempo integral como editor (85,3%) e 88,2% recebem algum pagamento. A maioria deles recebeu treinamento para a posição de editor (55,9%). O CONSORT Statement foi endossado por 61,8% dos periódicos. Informações oriundas dos sites demonstraram que 44,4% dos periódicos não recomendam nenhum guia de reporte, 51,9% mencionam o CONSORT Statement no site e 28,4 apenas recomenda o CONSORT Statement. Existe um espaço claro para melhora no uso de guias de reporte em periódicos de odontologia. Um maior entendimento e endosso/aderência/implementação de guias de reporte por periódicos de odontologia pode promover a qualidade e transparência das pesquisas odontológicas publicadas.

Three-dimensionally printed interim restorations are among the recent technological advancements in dentistry. However, evidence of their performance is lacking.The purpose of this in vitro study was to compare the properties of interim restorations made by 3D printing with different technologies, laser stereolithography (SLA), technology and selective laser sintering (SLS) with those obtained by conventional techniques from acrylic resin and bis-acryl resin.Four different groups (acrylic resin, bis-acryl resin, SLS, SLA) were tested for flexural strength, Vickers microhardness, fatigue test, compressive strength, surface roughness before and after polishing, and biofilm formation. Specimens were made in the form of rectangular blocks, disks, and single crowns by following the manufacturing technique of each material. One-way ANOVA was used to test biofilm formation, Vickers microhardness, and the results of the 3-point bend flexural test, while the paired t test was used to assess differences in surface roughness between the materials (α=.05 for all tests).The highest Vickers microhardness value was for acrylic resin interim crowns, while the elastic moduli were lower for both the 3D printed materials. Only the SLA resin fractured during the fatigue test. For surface roughness, a statistically significant difference was found among the studied materials (P.001), with SLA resin and bis-acryl resin having the lowest values. No statistically significant differences were found for biofilm formation (P.05).SLS resin had favorable results for the Vickers microhardness, higher maximum flexural strength, and peak stress in load-to-fracture tests, the fatigue test, and biofilm formation compared with acrylic resin and bis-acryl resin, while SLA resin showed favorable results only for biofilm formation and surface roughness.

The effect of root canal preparation technique on microcrack initiation is a controversial issue. This systematic review aimed to assess the role of root canal preparation techniques with different kinematics (manual, rotary, reciprocating, adaptive, self-adjusting file) on microcrack initiation. In vitro and in situ studies comparing the influence of at least two different root canal preparation techniques on the initiation of dentin microcracks were searched in PubMed/MEDLINE and SCOPUS up to June 5, 2018 without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and the included studies were assessed for bias. Fifty-four (n=54) articles met the eligibility criteria. The results were classified according to the method used for microcrack evaluation, and most studies that used micro-computed tomography showed no formation of new cracks after root canal preparation. In general, the instrumentation techniques induced microcrack formation when the methods were destructive, irrespective of kinematics. In relation to the apex region, when the preparation working length was set as the root canal length subtracted of 1 mm, the risk of microcrack initiation reduces. The majority of the included studies had low risk of bias for all assessed domains. Our results seem to indicate that the various root canal preparation techniques considered in this study will not cause damage to the dental structure when adequately employed and the proper methodology is applied. Resumo O efeito da técnica de preparo do canal radicular na iniciação e/ou propagação de microfissuras dentinárias é um tema controverso. Essa revisão sistemática teve como objetivo avaliar o papel das técnicas de preparo do canal radicular com diferentes cinemáticas (manual, rotatória, reciprocante, adaptativa e self-adjusting file) na iniciação e/ou propagação de microfissuras dentinárias. Estudos in vitro e in situ comparando a influência de pelo menos duas técnicas diferentes de preparo do canal radicular foram identificados no PubMed/MEDLINE e SCOPUS até 05 de junho de 2018 sem restrição de idioma e tempo. Dois autores revisaram de maneira independente todos títulos e resumos para elegibilidade dos estudos. Tabelas foram criadas para sumarizar os estudos incluídos e os estudos foram avaliados quanto ao risco de viés. Cinquenta e quatro (54) estudos enquadraram-se nos critérios de elegibilidade. Os resultados foram classificados de acordo com o método utilizado para avaliação das microfissuras. A maioria dos estudos que utilizaram micro-tomografia não demonstraram formação de novas microfissuras após preparo do canal radicular. Em geral, técnicas de instrumentação induziram formação de microfissuras quando os métodos de avaliação foram destrutivos, independente da cinemática. Em relação a região do ápice, quando comprimento de trabalho foi definido como o comprimento do canal menos 1 mm, o risco de indução de microfissuras é reduzido. A maioria dos estudos incluídos apresentaram baixo risco de viés para todos os domínios apresentados. Nossos resultados parecem indicar que as diferentes técnicas de preparo do canal radicular não causam danos a estrutura dental quando adequadamente utilizadas e a metodologia adequada é utilizada.

This study aimed to assess the prevalence of bruxism and its relationship with common mental disorders (CMD) during the life course of individuals.A representative sample (n = 537) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated regarding their oral health. The CMD screening was assessed through Self-Reported Questionnaire-20 (SRQ-20) at ages 22 and 30. Bruxism information was collected in the oral health survey at the age 31. Exploratory variables included demographic and socio-economic, mental health and unhealthy behaviours. Multivariate Poisson Regression analysis was used to estimate the association between bruxism and CMD.Bruxism prevalence was 41.1% at 31 years old. Presence of bruxism was positively associated with females (p = 0.003), lower school level (p = 0.001), and smoking habits (p = 0.021). CMD episodes were associated with bruxism (p 0.001). Individuals presenting CMD at age of 30 years presented a 57% higher prevalence (PR 1.57; 95%CI 1.14-2.15) of bruxism, while in those individuals who presented CMD in both follow-ups (at 22 and 30 years old) the bruxism prevalence was 70% higher (PR 1.70; 95%CI 1.28-2.25).Subjects presenting signals and symptoms of common mental disorders during their life course presented higher prevalence of bruxism.The presence of common mental disorders during life course impacts in the presence of bruxism in the adulthood. In addition, more episodes of common mental disorders were associated with higher prevalence of bruxism.

A nationwide survey of dentists was carried out in Brazil, a new pandemic epicenter, to analyze how dental coverage has been affected (public versus private networks), changes in routine and burdens, and how the local prevalence of COVID-19 affects dental professionals. Dentists were recruited via email and an Instagram® campaign. Responses to an online questionnaire were collected May 15–24, 2020. COVID-19 case/death counts in the state where respondents work was used to test associations between contextual status and decreases in weekly appointments, fear of contracting COVID-19 at work, and current work status (α=0.05). Over 10 days, 3,122 responses were received, with region, gender, and age distributions similar to those of dentists in Brazil. Work status was affected for 94% of dentists, with less developed regions being more impacted. The impact on routine was high or very high for 84%, leading to varied changes to clinic infrastructure, personal protective equipment use, patient screening, and increased costs. COVID-19 patients had been seen by 5.3% of respondents, and 90% reported fearing contracting COVID-19 at work. Multilevel statistics showed that greater case and death rates (1000 cases or 100 deaths/million inhabitants) in one’s state increased the odds of being fearful of contracting the disease (by 18% and 25%). For each additional 1000 cases or 100 deaths, the odds of currently not working or treating emergencies increased by 36% and 58%. The reduction in patients seen weekly per dentist was greater in public (38.7±18.6) than in private clinics (22.5±17.8). This study provides early evidence of three major impacts of the pandemic on dentistry in Brazil: increasing inequalities due to coverage differences between public and private networks; adoption of new clinical routines, which are associated with an economic burden; and associations of regional COVID-19 incidence and mortality with fear of contracting the disease at work.

Objective: The aim of this study was to compare the accuracy of three different modes of a spectrophotometer (Vita Classical, 3D-Master and CIE L*a*b* system) in the evaluation of color alteration in endodontically treated teeth. Material and Methods: The root canal treatment of forty-five sound human canines was performed. Color measurements were performed before the endodontic treatment (baseline), andafter6monthsof water storage. Shade matching was performed using a spectrophotometer (Vita Easyshade) in three different modes: Vita Classical, 3D-Master and CIE L*a*b* coordinates. The color change (?E value) for the three methods were assessed in each sample and analyzed by multiple linear regression analysis. L*, a* and b* values were analyzed by t-test. The significance level was set at 5%. Results: According to the digital evaluation, no statistically significant differences were found between the CIE L*a*b*,Vita Classical and 3D-Mastermodes. However, a significant difference was found (p

A literature review was performed including studies that evaluated the use of cleaning protocols for removable dentures through questionnaires, clinical trials, randomized clinical trials, and systematic reviews. Twenty studies were included and the results showed that bad preservation of the prostheses is mainly due to low knowledge about cleaning habits and methods. Also, a wide variety of effective cleaning methods were presented. However, there is no standard protocol for all patients and it should be customized for each patient. It is important to highlight that dentists should give adequate instructions concerning maintenance and hygiene of the prosthesis. KeywordsDental prosthesis; Oral hygiene; Oral health.

Objectives A systematic review was conducted to evaluate clinical (survival) and in vitro (fracture strength) studies of endocrown restorations compared to conventional treatments (intraradicular posts, direct composite resin, inlay/onlay). Data This report followed the PRISMA Statement. A total of 8 studies were included in this review. Sources Two reviewers performed a literature search up to February 2016 in seven databases: PubMed, Web of Science, Scopus, BBO, SciELO, LILACS and IBECS. Study selection Only clinical trials and in vitro studies that evaluated endocrowns were included. Case reports, case series, pilot studies, reviews and in vitro studies that evaluated properties other than fracture strength of endocrowns were excluded. From the 103 eligible articles, 8 remained in the qualitative analysis (3 clinical trials and 5 in vitro studies), and the meta-analysis was performed for the 5 in vitro studies. A global comparison was performed with random-effects models at a significance level of p Results Clinical trials showed a success rate of endocrowns varying from 94 to 100%. The global analysis in posterior and anterior teeth demonstrated that endocrowns had higher fracture strength than conventional treatments (p = 0.03). However, when comparing endocrowns to conventional treatments only in posterior teeth (subgroup analyses), no statistically significant differences were found between treatments (p = 0.07; I2 = 62%). Conclusion The literature suggests that endocrowns may perform similarly or better than the conventional treatments using intraradicular posts, direct composite resin or inlay/onlay restorations. Clinical significance Although further studies are still necessary to confirm the present findings, endocrowns show potential application for the rehabilitation of severely compromised, endodontically treated teeth.

Direct and indirect techniques are used for intracanal impression and fabrication of cast metal posts. However, whether those techniques affect the accuracy of cast metal posts is unknown.The purpose of this randomized clinical trial was to evaluate the accuracy of cast metal posts depending on tooth position and impression technique.Endodontically treated teeth (anterior or posterior) planned to receive cast metal posts and complete crowns were randomized according to impression technique (direct or indirect). Impressions were made by 2 operators, and time for the impression was recorded. All impressions and cast metal posts were photographed to assess any possible differences between techniques in length of the cast metal post.All cast metal posts were shorter than the impressions. The mean reduction for the metal posts was 2.3% for direct in anterior teeth, 5.7% for direct in posterior teeth, 6.3% for indirect in anterior teeth, and 7.2% for indirect in posterior teeth (all P.05). Statistically significant differences were found between time of technique and tooth position (P=.031), with the direct technique more time consuming than the indirect technique (P.001) for both tooth positions. For the indirect technique, the impression times for both tooth groups were similar (P=.459).Both of the intracanal impression techniques resulted in cast posts that were shorter than the impressed post space. The discrepancy was greatest for the indirect technique. Nevertheless, all posts were considered clinically acceptable and were cemented.

The aim of this study was to systematically review the literature for laboratory and clinical studies to evaluate the effect of ferrule in restored endodontically treated teeth. The search was conducted in 2 databases (PubMed, Scopus) with no publication year/language limits. From 1,872 potentially eligible studies, 124 studies were selected for full-text analysis, and 37 were included for review, with 32 of those considered in the meta-analysis and 5 considered in the survival analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. For laboratory studies, a meta-analysis was performed for the comparison of the fracture resistance of teeth with and without ferrule, and 3 subgroup analyses were conducted for ferrule height, post type, and type of tooth. For clinical studies, the Kaplan-Meier method was used to determine the survival of restorations, with log-rank test used to identify differences between groups ( α = 5%). Teeth without ferrule had a lower fracture resistance ( P < 0.00001), and the higher the height of ferrule, the greater the fracture resistance was, irrespective of the type of post ( P < .000001). Teeth with ferrule had higher clinical longevity ( P = 0.002); however, the presence of a ferrule was related to higher survival only for premolars ( P = 0.05). In conclusion, the presence of a ferrule is responsible for an improvement in the fracture resistance of the restoration in laboratory studies. Yet, other clinical factors besides the ferrule may be associated with survival in molars and anterior teeth and need to be further investigated. Knowledge Transfer Statement: The results of this study can be used by clinicians when deciding which approach to use when planning the restoration of endodontically treated teeth with and without ferrule. Ferrule may lead to higher tooth/restoration survival, while tooth location may influence therapeutic decisions.

To investigate the mechanical performance and fracture behavior of endocrown restorations prepared using different composite materials and following a direct technique.Sound molars were cut at 2 mm above the cementoenamel junction, endodontically treated, and allocated according to the type of restoration (n = 7): without post (endocrowns) or with post (post-retained restorations). Endocrowns were fabricated with conventional composite (Filtek Z350); bulk fill composite (Filtek Bulk Fill); conventional composite modeled using resin adhesives (SBMP: Scotchbond Multipurpose Adhesive; or SBU: Scotchbond Universal Adhesive); and lithium disilicate ceramic (E.max; Positive control). The post-retained restorations were fabricated with glass-fiber post combined with conventional or bulk fill composites. All restorations were bonded following an etch-and-rise adhesive approach or self-adhesive resin cement. The teeth were submitted to fatigue (Byocycle) and compression (EMIC DL500) testing at a crosshead speed of 1 mm/min. Data were analyzed with ANOVA and Tukey (p 0.05) and Weibull analysis was carried out in order to evaluate the reliability of restorations.The bulk-fill-based endocrown showed a stronger performance than the control. The presence of SBMP or the use of bulk-fill composite resulted in the occurrence of less aggressive fractures than the other restorative systems. Endocrowns bonded directly to the tooth seemed to produce similar fracture strength properties as compared to endocrowns bonded using self-adhesive resin cementation. The bulk-fill-based endocrown showed the greatest reliability of study.Resin-based restorative materials seem to be interesting alternative options to fabricate large dental restorations in lieu of the more traditionally used glass ceramics or root canal post systems.

Contains fulltext : 229072.pdf (Publisher’s version ) (Closed access) BACKGROUND: The best treatment option for large caries in permanent posterior teeth is still a matter of uncertainty in dental literature. The authors conducted a network meta-analysis to address the challenges related to rehabilitation of these teeth. TYPES OF STUDIES REVIEWED: The authors selected prospective and retrospective studies that compared at least 2 different treatment alternatives for permanent teeth with a minimum of 5 years of follow-up. The authors searched databases from MEDLINE, Scopus, Cochrane Library, and Web of Science in October 2019 without language or year of publication restrictions. RESULTS: From 11,263 studies identified, 43 studies fulfilled the eligibility criteria and were included in the final review. Only 13 studies were randomized controlled trials and were classified as low risk of bias. Gold (annual failure rate of 0.29%) and metal ceramic (annual failure rate of 0.52%) crowns performed better for indirect restorations and direct resin composite performed better for direct restorations (annual failure rate of 2.19%). The most substantial comparisons were between feldspathic and glass ceramics, followed by direct resin composite and amalgam; there were no statistically significant differences between these interventions. Results of the pairwise meta-analysis showed mainly glass ionomer as significantly more prone to failure than amalgam and direct composite resin. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Reference standard direct and indirect materials except for glass ionomer can be used for restorations of large posterior caries.

Objective: to assess the characteristics associated withtemporomandibular disorders (TMD) and their impacton oral health-related quality of life (OHRQoL) of institutionalizedelderly people. Subjects and method: itwas a cross-sectional study performed in 30 private institutionsfor the elderly. The data collected included theTMD questionnaire and clinical evaluation assessed bythe Research Diagnostic Criteria/TemporomandibularDisorders (RDC/TMD), as well as the OHIP-49 questionnairefor OHRQoL. Results: twenty-four institutionsaccepted to participate in the study (n = 375 with 133fit for answering both questionnaires). Considering thecharacteristics, tinnitus was the most frequent symptomreported, while 98.5% of the research participants didnot present myofascial pain. Disc displacement wasobserved in 26.3%, while 93% of individuals did notpresent chronic pain. Severe depression was found in23.3% of the elderly with 24.1% presenting moderatelevels of non-specific physical symptoms, includingpain. Poisson regression analysis showed that the characteristicsreported were associated with a negativeimpact on OHRQoL. Conclusion: the domain-specificanalysis showed that all domains were affected negativelyby TMD characteristics and higher levels of depressionare associated with a negative impact on OHRQoL. Keywords: Elderly people. Oral health-related qualityof life. Temporomandibular disorders. Facial pain. Depression.

The aim of this systematic review and meta-analysis was to evaluate the efficacy of cryotherapy in reducing pain, trismus, and facial swelling in patients undergoing third-molar surgery.The authors searched for randomized clinical trials in PubMed, Web of Science, SCOPUS, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Google Scholar, and OpenThesis. Eligibility criteria were population: patients submitted to removal of impacted third molars; intervention and comparison: postoperative cryotherapy versus no cold therapy; and outcomes: primary outcome was postoperative pain, and secondary outcomes were facial swelling and trismus. Eligible studies must have reported at least 1 of the outcomes of interest. After extracting data and assessing quality, the authors performed the meta-analyses.The authors included 6 studies in the quantitative synthesis analysis. Differences in pain intensity were found on postoperative day 2 (weighted mean difference, -0.72; 95% confidence interval, -1.45 to 0.01; P = .05) and postoperative day 3 (weighted mean difference, -0.36; 95% confidence interval, -0.59 to -0.13; P = .002). No evidence was found that cryotherapy was effective in reducing trismus and facial swelling. The quality of evidence was graded as low.Evidence suggests that cryotherapy may have a small benefit in reducing pain after third-molar surgery, but it is not effective on facial swelling and trismus. Owing to the lack of standardization of cold application, effective evidence-based treatment protocols for cryotherapy after third-molar surgery still need to be established.

The aim of this study was to investigate the mechanical performance and the fracture behavior of endocrown restorations prepared using distinct restorative materials. A total of 42 sound molars with similar crown size and shape were cut at 2 mm above the cementoenamel junction and endodontically treated. They were categorized according to the restorative material used to fabricate endocrown restorations (n=7), namely, conventional composite (Filtek™ Z350 XT), bulk fill composite (Filtek™ Bulk Fill), conventional composite modeled using resin adhesives (SBMP: Scotchbond™ Multipurpose Adhesive; or SBU: Scotchbond™ Universal Adhesive), and IPS e.max lithium disilicate (Ivoclar Vivadent; positive control). Unprepared sound teeth were used as negative control. All endocrowns were bonded using a self-adhesive cement (Rely-X™ U200). The teeth were submitted to fatigue (Byocycle) and fracture (EMIC DL500) testing. Load-to-fracture (in N) and work-of-fracture (Wf, in J/m2) values were analyzed by ANOVA (p < 0.05). The endocrowns did not fracture or de-bond upon fatigue, showing similar load-to-fracture and work-of-fracture values, regardless of the restorative material (p > 0.05). The endocrowns fabricated by combining Z350 and SBMP had the least harsh fractures, in contrast to endocrowns prepared using Z350 only, which exhibited an equilibrium between repairable and irrepairable fractures. The e.max endocrowns exhibited more aggressive failures (root fracture) than other groups, resulting in higher rates of irrepairable fractures. In conclusion, dental practitioners may satisfactorily restore severely damaged nonvital teeth using the endocrown technique. Composite endocrowns prepared using resin adhesive as modeler liquid or using bulk fill material may result in less aggressive failures, thus providing a new material perspective for endocrown restorations.

SUMMARY Objectives: The aim of this prospective randomized multicenter clinical trial was to evaluate the survival rate of glass fiber–reinforced posts cemented with self-adhesive or regular resin cements. Methods: The sample was comprised of 152 teeth randomized within two centers and in accordance with the adhesive strategies for RelyX U100/U200 (3M ESPE) or Single Bond and RelyX ARC (3M ESPE). The cementation procedures were standardized and performed by previously trained operators. The primary outcome evaluated was post debonding. A trained evaluator, one for each center, assessed all subjects at intervals of 12 months for up to 6 years. Statistical analysis was performed using the Kaplan-Meier method. Results: There was no statistically significant difference in survival rates between the two strategies assessed (p=0.991), with a 92.7% survival rate for the self-adhesive cement and 93.8% for the regular cement. Conclusion: Both the self-adhesive and the regular resin cements are good alternatives for glass fiber post cementation.

Contains fulltext : 153695.pdf (Publisher’s version ) (Open Access) The aim of this study was to evaluate if clinical experience, whether in relation to length of practice time and/or level of specialization influences the dentist's preference for using posts to restore endodontically treated teeth. A cross sectional study was carried out using a questionnaire with dentists (n = 276) in Pelotas, southern Brazil. Data were collected regarding clinical experience, post-graduate training, and variables related to restorations (posts/cements and use of rubber dam) for endodontically treated teeth. The data were submitted to a descriptive analysis and associations were tested. The response rate was 68%. Cast metal posts (24.53%), glass fiber posts (20.75%) and resin cement (66.67%) were the most commonly selected materials. In relation to rubber dams, 93.05% of the dentists were found not use them to lute posts. There was a significant association between the level of training of post-graduate dentists and the type of post used (p = 0.027), in that dentists without post-graduate training used cast metal posts more frequently, whereas dentists with post-graduate training reported glass fiber posts as their first choice. The results of the study showed that dentists preferred cast metal posts, glass fiber posts and resin cement. Continuing education influenced the decision of the dentists on their choice of dental posts.

Statement of problem Clinical evidence on the best chemical protocol for the disinfection and removal of biofilm from complete dentures is lacking. Purpose The purpose of this crossover randomized clinical trial was to assess the effectiveness of various chemical hygiene clinical protocols in reducing the microbial viability of biofilm formed on complete dentures. Material and methods In this triple-blind (participants, dentist, and outcome evaluator) study, complete denture wearers without candidiasis were randomly divided into 4 groups (n=40) according to the chemical hygiene protocol: water (placebo), 0.5% sodium hypochlorite solution, 0.12% chlorhexidine gluconate solution, and 5% sodium bicarbonate solution. The biofilm formed on the palate intaglio and denture teeth was collected and assessed in each experimental phase for quantitative microbial viability at the seventh and 14th day after using the chemical protocol. Results Two participants were lost. Data were analyzed by MANOVA and Tukey HSD tests. Soaking dentures was not effective in decreasing Candida albicans, C. non-albicans, and lactobacillus counts. The use of sodium hypochlorite and chlorhexidine decreased total microorganisms and Streptococcus mutans counts for both palate and teeth compared with water and sodium bicarbonate. The intaglio of the dentures always presented higher microbial counts than did the denture teeth. Conclusions The use of sodium hypochlorite and chlorhexidine and mechanical cleansing with a toothbrush decreased microbial viability in healthy complete denture wearers.

Resin cements are often used for single crown cementation due to their physical properties. Self-adhesive resin cements gained widespread due to their simplified technique compared to regular resin cement. However, there is lacking clinical evidence about the long-term behavior of this material. The aim of this prospective clinical trial was to assess the survival rates of metal-ceramic crowns cemented with self-adhesive resin cement up to six years. One hundred and twenty-nine subjects received 152 metal-ceramic crowns. The cementation procedures were standardized and performed by previously trained operators. The crowns were assessed as to primary outcome (debonding) and FDI criteria. Statistical analysis was performed using Kaplan-Meier statistics and descriptive analysis. Three failures occurred (debonding), resulting in a 97.6% survival rate. FDI criteria assessment resulted in scores 1 and 2 (acceptable clinical evaluation) for all surviving crowns. The use of self-adhesive resin cement is a feasible alternative for metal-ceramic crowns cementation, achieving high and adequate survival rates.

The aim of this study is to evaluate the influence of modeling liquids on the translucency and color shade of resin composites (RCs) after one year of storage. RC specimens were prepared using either a conventional insertion technique (control; without modeling liquid) or a restorative dental modeling insertion technique (RDMIT) with dental adhesives as modeling liquids (Scotchbond™ Multi-Purpose [SBMP; 3M ESPE] or Adper™ Single Bond 2 [SB; 3M ESPE]). The initial colors of the specimens were obtained with a digital spectrophotometer and the CIEL*a*b* color system, after which specimens were stored (37°C) in distilled water or red wine for 12 months. Color measurements were reassessed after 6 and 12 months of storage, and scanning electron microscopy was performed after 12 months. Translucency and color change (ΔE*) were calculated and analyzed using ANOVA and Tukey’s test (α = 5%). RC samples prepared via RDMIT showed a translucency similar to that of control samples. ΔE* was also less intense for RCs containing SBMP than for RCs containing SB. Specimens stored in wine showed a clear pattern of degradation, especially in the control group, and surface degradation seemed to be less intense for specimens prepared with SBMP and SB than for specimens without. Specimens stored in water did not show clear evidence of surface degradation. RDMIT appears to be an interesting approach to reduce ΔE* in RCs over time without negative effects on the translucency of the material. However, the modeling liquid should feature a hydrophobic composition, similar to that used in the SBMP group, the achieve the best results.

Self-adhesive resin cements are gaining increasing popularity in dentistry because they simplify the cementation protocol by eliminating the etching, priming, and bonding steps. Due to the scarce literature on the clinical performance of glass fiber posts luted using different adhesive strategies, clinicians have difficulty in selecting the most appropriate resin cement system. This Critical Appraisal will review in vitro and clinical studies regarding the luting of fiber posts with self-adhesive materials.

Objective This randomized controlled trial compared the survival of glass fibre and cast metal dental posts used to restore endodontically treated teeth with no remaining coronal wall. Methods Fifty-four participants (45 women) and 72 teeth were evaluated during a follow-up period of up to 3 years. Teeth were randomly allocated to the glass-fibre and cast-metal post groups. All teeth were restored with single metal-ceramic crowns. Survival probabilities were analyzed using Kaplan–Meier statistics (p ≤ 0.05). Results The 3-year recall rate was 92.3% and the survival rates of glass fibre and cast metal posts were similar (97.1% and 91.9%, respectively; p = 0.682). Four failures were observed: two glass fibre posts in a premolar and anterior tooth debonded, one glass fibre post in a premolar debonded in association with root fracture, and one root fracture occurred in a molar with a cast metal post. Conclusions Glass fibre and cast metal posts showed similar clinical performance in teeth with no remaining coronal wall after 3 years. Clinical Significance Posts are used to restore most endodontically treated teeth with no remaining coronal wall. This randomized controlled trial, one of few to compare glass fibre and cast metal posts in such teeth, showed that post type did not significantly influence the survival of restorations. These results can help dentists respond to the important question of how best to rehabilitate endodontically treated teeth with no remaining coronal wall.

El objetivo del presente estudio es abordar el tema de la erosion dental desde otro punto de vista. Al tener en cuenta la creciente tasa de incidencia de esta lesion dental en ninos y adultos, el trabajo plantea la pregunta sobre el peligro de la ingesta indiscriminada de ciertos alimentos acidos y bebidas que han sido identificados cientificamente como una de las causas de la erosion dental, como asimismo, una completa falta de informacion por parte la industria alimentaria sobre estos productos. Se presentan algunos puntos que aun quedan en duda referente a este tema y algunos enfoques que se deben tomar para alertar a lapoblacion acerca de la relacion entre la acidez de los alimentos y la erosion dental.