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Resin cement and preheated restorative resin composite may be used for luting laminate veneers. The main advantage of resin composite is increased wear resistance, which could lead to better marginal performance in long term. This article reports a clinical treatment with feldspar laminate veneers luted to the maxillary teeth with preheated resin composite in a private practice. Case was finalized in May 2009 and followed by 10 years. Excellent clinical service and remarkable long-lasting marginal integrity were observed after 123 months. Scanning electron microscopy analysis showed no wear, gaps, or ditching at the margins. Restorative margins showed a smooth transition between ceramic and tooth with no signs of degradation. Preheated resin composite for luting ceramic laminate veneers may be considered an excellent clinical option.

This study identified charcoal-based dentifrices and abrasive powders sold in Brazil and analyzed their label information. The products were searched in four online shopping platforms. The same products were searched on Instagram and their engagement metrics were investigated. Furthermore, a literature review of international publications assessing charcoal dentifrices and powders was conducted, and altmetrics were collected (Altmetric and PlumX). Thirty-six products were found with prices between $0.4-22 USD. Most frequent words in product description were sodium, stain, whitening, oil, xylitol, and coconut. Only 3 products contained fluoride. Bactericidal, antiviral, antifungal, and anti-inflammatory activities were indicated, in addition to non-scientific claims such as calming teeth or increasing oral immunity. In total, 72% of products had Instagram profiles, which generally showed low engagement rates (81%) and medium audience quality scores (65%). Twenty-two articles were found in the literature, from which 21 were in vitro studies. The single clinical study was sponsored by a charcoal product and had no control group. In total, 23% of studies showed positive results and 55% reported negative results for the charcoal products, which included no whitening ability, increased roughness, surface alterations, and lower demineralization prevention ability. Altmetric scores for the included articles varied from 0 to 55, with 40.9% of studies mentioned online. In conclusion, charcoal-based products are using marketing strategies on Instagram but their current engagement with the public is not high. Consumers are being exposed to charcoal products whose potential risks to health are still unknown.

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

To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.

Objective The aim of this study was to evaluate the effect of different photoinitiator systems on the cell viability and physico-chemical properties of an experimental adhesive resin of a two-step self-etch adhesive system. Methods Eight photoinitiators and coinitiators were evaluated, camphorquinone (CQ); ethyl-dimethylamino benzoate (EDAB); diphenyliodonium hexafluorophosphate (DPIHFP); 1,3-benzodioxole (BDO); piperonyl alcohol (AP); 1,3-diethyl-2-thiobarbituric acid (TBA); bisphenyl phosphinic oxide (BAPO); and diphenyl phosphinic oxide (TPO). Seven experimental adhesive resins (Bis-GMA:TEGDMA – 1:1 by wt%) were formulated by varying the initiation systems: RCQ+EDAB (control), RCQ+EDAB+DPHFP, RCQ+BDO, RCQ+AP, RCQ+TBA, RBAPO and RTPO. The cell viability of the different photoinitiators in their isolated form and after being incorporated into the adhesive resins was evaluated using the MTT assay. The degree of conversion within the hybrid layer (DC in situ) was evaluated by micro-Raman spectroscopy; the polymerization kinetics, by FTIR spectroscopy. The water sorption (Wsp) and solubility (Wsl) were calculated by using percentage of gain and loss of mass. Data were analyzed using One-way ANOVA and Kruskal-Wallis tests (α = 0.05). Results When evaluated in their isolated form, the DPIHFP was considered cytotoxic in all concentrations evaluated. When incorporated into and adhesive resin, RCQ+TBA presented higher cell viability values than control and the highest values of DC in situ (p Significance The pair CQ + TBA could be potentially useful in the development of materials with improved biocompatibility.

This cross-sectional survey investigated the pandemic impact on dental practice in May 2021 (second wave in Brazil). COVID-19 incidence and severity among respondents, vaccination status, and level of confidence in vaccines were surveyed, in addition to medications used for preventing or treating COVID-19, including controversial drugs/substances (vitamin D, ivermectin, zinc, and chloroquine). Dentists were recruited by email and responded to a pretested questionnaire until May 31, 2021. In total, 1,907 responses were received (21.2% return rate). Bivariate and multivariate regression analyses were performed (α=0.05). Prevalence Ratios were calculated for the association between professional characteristics and two outcomes: report of SARS-CoV-2 infection and use of controversial drugs. One third of dentists reported intermediate levels of confidence in safety/efficacy of vaccines, but 96% received at least one vaccine dose, mainly CoronaVac. The impact of the pandemic on dental practice was rated as lower/much lower compared with one-year before (first wave) by 46% of respondents; 27% of dentists reported to have had a positive COVID-19 test, ~50% had relatives or friends who had been hospitalized or died from COVID-19. At least one medication was used by 59% of respondents, 43% used two or more drugs and substances. Vitamin D (41%), (35%), and zinc (29%) were the most frequent drugs/substances. More experienced dentists (≥21 years in practice) were 42% more likely to use controversial medications than less experienced respondents. Dentists with residency/advanced training as postgraduate education had 30% higher prevalence of controversial medication use than respondents holding MSc/PhD degrees. Respondents with low confidence in vaccines were 2.1 times more likely to use controversial medications than participants with very high confidence. The overall findings of this survey highlight the high severity of the pandemic in Brazil, and raised questions about the use of scientific evidence by dentists in their decision to take controversial COVID-19 medications.

Objective: of this study was to characterize and correlate the absorption spectra of three photoinitiators [camphorquinone (CQ), diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) and phenylbis (2,4,6-trimethylbenzoyl)-phosphine oxide (BAPO)], using second or third-generation light curing units (LCU), and to evaluate the degree of conversion and the physical properties of an experimental resin adhesive. Material and methods: Second-generation (Radii-cal® and Emitter D®) and third-generation (Valo® Cordless and Bluephase N®) LCU were assessed regarding spectrum and irradiance rate of emitted light. Also, the photoinitiators (CQ, TPO and BAPO) were characterized by a light absorption spectrum assessed by UV-Vis spectroscopy, degree of conversion and yellowing effect. Statistical analyzes considered two-way ANOVA and post-hoc Tukey test. Results: BAPO presented higher reactivity compared to TPO. Regarding degree of conversion of the photoinitiators activated by different light-curing units, the Emitter D® device promoted a high degree of conversion. BAPO presented the highest yellowing effect values. Conclusions: The emission and absorption characteristics of the photoinitiators were different. The polymerization reaction activated by the second-generation light-curing unit was reduced when using an experimental resin with photoinitiator TPO, and the third-generation light-curing unit showed a higher polymerization potential regardless of the photoinitiator. Keywords Light-curing of dental adhesives; Photoinitiators dental; Curing lights dental.

Background: The COVID-19pandemic has significantly impacted the dental sector worldwide.Methods: The impact of the pandemic on dentistsfrom Latin America was investigated by an online survey with professionals working in 11 Spanish-speaking countries in September–December 2020. The invitations were sent to registered professionals. An open campaign was promoted on social media. The questions investigated dental care routines, work practice changes, andfeelings about the pandemic, in addition toreasons for engaging in furthersurveys.Descriptive statistics were used to identify frequencies and distributions of variables. Proportions were compared using chi-square tests.Results: A total of 2,127 responses were collected from a samplewith diverse demographic, sex, work, and education characteristics. The impact of the pandemic was considered high/very high by 60% of respondents.The volume of patients assisted weekly was significantly lower compared with the pre-pandemic period (mean reduction=14 ±15 patients). A high rate of fear to contracting the COVID-19 at work was observed (85%); 4.9% of participants had a positive COVID-19 test. The mask most frequently worn was PFF2/N95 (42%). The main professional challenges faced by respondents were reduction in the number of patientsor financial gain (35%), fear of contracting COVID-19 (34%), and burden with or difficulty in purchasing new PPE (22%).The fear to contracting COVID-19 was influenced by the number of weekly appointments. A positive test by the dentists was associated with their reports of having assisted COVID-19 patients. The most cited feelings about the pandemic were uncertainty, fear, worry, anxiety, and stress. When asked about incentives to participating in further surveys, the most common responses were receiving articles that originated from the investigation (44%)and priority access to research data (15%). Conclusion:This multi-countrysurvey indicated a high impact of the pandemic on dental care routines in Latin American offices.

Restoring a single darkened central incisor can be challenging. Both direct and indirect options may be acceptable to mask discoloration and achieve functional requirements. This report describes placement of a modified feldspathic porcelain veneer to reproduce the appearance of a maxillary central incisor discolored after trauma.

To evaluate the effects of pretreatment with different crosslinking agents on glass-fiber-post adhesive luting.Single-rooted human teeth (n = 20) were randomly assigned to four groups: proanthocyanidins (PA) from grape-seed extract, cardol and cardanol (separated from cashew nut-shell liquid) and negative control (hydroethanolic solution). The solutions were applied on 37% phosphoric acid-etched dentin for 60 s. Glass-fiber posts were cemented using a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M Oral Care) and composite cement (RelyX ARC, 3M Oral Care). Slices for the push-out bond strength test were cut and tested after 24-h or 6-month storage in distilled water. The dentin underlying the adhesive layer was analyzed by micro-Raman spectroscopy to evaluate vibrational formation of collagen crosslinks. Three additional slices per group were also made and the adhesive in-situ degree of conversion (DC) was analyzed by micro-Raman spectroscopy. The results were analyzed using two-way ANOVA and Tukey's test (p0.05).No statistically significant changes in bond strength were found over time for any of the groups, except with cardol, which increased bond strength (8.4 ± 3.9 MPa at 24 h to 15.0 ± 2.9 MPa after 6 months, p0.001) after aging. The formation of peaks at 1117 cm-1 and 1235 cm-1 showed the presence of collagen crosslinks for all three biomodification agents. The DC outcomes showed no statistically significant differences between groups (p = 0.514).Biomodification agents did not impair adhesive polymerization. Cardol demonstrated a positive influence on intraradicular dentin bonding for glass-fiber post luting.

Objetivo: Avaliar o efeito do envelhecimento térmico por termociclagem na estabilidade de cor e rugosidade superficial de duas resinas compostas, avaliar grau de conversão (GC), sorção (SO), solubilidade (SL) e microdureza. Material e método: Foram confeccionados 10 espécimes (6 mm x 1 mm) para cada resina: Filtek Z350 XT (Z350XT) e Estelite Sigma Quick (ES). Foram avaliados: GC, utilizando um espectrofotômetro no infravermelho, SO e SL. A avaliação da microdureza Vickers (MV) e densidade de ligações cruzadas foram realizadas antes e após a imersão em etanol por 24h. A rugosidade superficial e a estabilidade de cor (CIEDE2000) foram avaliadas antes e após envelhecimento térmico por 2 mil ciclos, alternando 30 s a 5º, 37º e 55ºC. A estabilidade de cor e translucidez foram avaliadas com um espectrofotômetro. Os dados foram submetidos ao teste t (α=0,05). Resultados: ES apresentou resultados de GC maiores (62,5% ± 3,7) que Z350XT (48,7% ± 6,9) (p=0,004). Ambas resinas apresentaram resultados de SO e SL similares. A MV final da ES diminuiu 13% com relação a inicial (p= 0,115). Z350XT apresentou diminuição de 17% (p=0,004). ES apresentou aumento de 115% na rugosidade superficial após a termociclagem (p= 0,001), enquanto a Z350XT apresentou diminuição de 35% (p= 0,299). ES apresentou menor alteração de cor (0,280 ± 0,093), quando comparado a Z350XT (0,549 ± 0,183). A translucidez foi similar para ambos materiais (ES=30,80; Z350XT=30,35). Conclusão: A termociclagem influenciou na alteração de cor e rugosidade superficial das resinas compostas, demonstrando que podem ser alteradas pela degradação na matriz polimérica.

This study assessed bibliometric characteristics of all articles published in Brazilian Dental Journal (BDJ) in its 30 years of existence (1990-2019) and factors associated with citation rates. A document search was carried out in Scopus in December, 2019 and information about the articles were exported, including citations. Type of study and main subject in each article were categorized. Number of citations was categorized in tertiles. Logistic regression models were used to assess the association between variables related to articles’ characteristics and number of citations. In 30 years, 1705 articles were published and 18507 citations received, with average 57 articles and 334 pages published yearly and 10.9 cites/doc. The most frequent types of study were laboratorial (63%), clinical (18.5%), and case reports (11%); the main subjects were dental materials (21.6%), endodontics (19.3%), and oral pathology/stomatology (13.1%). Most articles had origin in Brazil (90%), followed by USA (4.6%) and UK (1.5%). Aside from BDJ, Journal of Endodontics (3.5%) and International Endodontic Journal (2.2%) were journals that most often cited BDJ. Main origins of citations were Brazil (36.7%), USA (10.6%), and India (9%). Older articles had higher odds to be highly cited (12% increase/year), longer articles had lower odds (9% decrease/page). Narrative reviews and epidemiological studies were associated with more citations and systematic reviews with less citations. In conclusion, BDJ covered many subjects and study types in 30 years, showing increased growth in international audience. The journal may be regarded as one of the leading Brazilian journals in dentistry published in English. Resumo Este estudo avaliou as características bibliométricas de todos os artigos publicados no Brazilian Dental Journal (BDJ) em seus 30 anos de existência (1990-2019) e fatores associados com taxas de citação. Uma busca pelos documentos foi realizada no Scopus em Dezembro de 2019 e informações acerca dos artigos foram exportadas, incluindo citações. Tipo de estudo e principal assunto em cada artigo foram categorizados. Número de citações foi categorizado em tercis. Modelos de regressão logística foram usados para avaliar a associação entre as variáveis relacionadas às características dos artigos e o número de citações. Em 30 anos, 1705 artigos foram publicados e 18507 citações recebidas, com média de 57 artigos e 334 páginas publicadas ao ano e 10,9 citações/documento. Os tipos de estudo mais frequentes foram laboratorial (63%), clínico (18,5%) e relato de caso (11%); os principais assuntos foram materiais dentários (21,6%), endodontia (19,3%) e patologia oral/estomatologia (13,1%). A maioria doas artigos teve origem do Brasil (90%), seguido dos EUA (4,6%) e Reino Unido (1,5%). Além do BDJ, Journal of Endodontics (3,5%) e International Endodontic Journal (2,2%) foram os periódicos que mais citaram o BDJ. As principais origem das citações foram Brasil (36,7%), EUA (10,6%) e Índia (9%). Artigos mais antigos tiveram maiores chances de serem altamente citados (aumento de 12% ao ano), artigos mais longos tiveram menores chances (redução de 9% por página). Revisões narrativas e estudos epidemiológicos foram associados com mais citações e revisões sistemáticas com menos citações. Em conclusão, o BDJ cobriu diversos assuntos e tipos de estudo em 30 anos, mostrando contínuo crescimento na audiência internacional. O periódico pode ser considerado um dos líderes entre as revistas brasileiras de odontologia publicadas em inglês.

This trial assessed post-operative pain and healing of apical periodontitis following endodontic therapy with a reciprocating system compared to a crown-down technique with hand files and lateral compaction filling. One-hundred and twenty nonvital anterior teeth with apical periodontitis were randomly treated using either a reciprocating single file followed by matching-taper single-cone filling or a hand file and lateral compaction filling. Postoperative pain was assessed during the 7 days after the treatment, using a visual analogue scale and a verbal rating scale. Apical healing was assessed using the periapical index score after a 12-month follow-up. The hypothesis tested was that both protocols were equivalent and present similar effectiveness in healing periapical lesions. Data were analyzed through two one-sided tests, t-tests, as well as Mann-Whitney and Chi-squared tests (α = 0.05). Logistic regression was used to investigate the association of clinical and demographic factors with the success of treatment. Regardless of the assessment time, no difference in incidence (38%-43% at first 24h), intensity of postoperative pain, and incidence of flare-up (≈ 3%) was observed between the two endodontic protocols. Both protocols resulted in a similar healing rate of apical periodontitis. After 12 months, the success rate ranged from 73% to 78% and the difference between the treatments fell within the pre-established equivalence margin (-0.1; -0.41 to 0.2). Endodontic treatment combining a reciprocating single file with matching-taper single cone showed similar clinical effectiveness to the treatment using hand-file instrumentation and the lateral compaction filling.

Objectives This study describes the synthesis of piperonyl methacrylate (PipM) and evaluates its effect when used as coinitiator in the photoinitiated radical polymerization of experimental adhesive resins. Methods PipM was synthetized through an esterification reaction and characterized by FTIR and 1H NMR spectroscopy. Adhesive resins containing camphorquinone as photoinitiator and PipM or ethyl-4-dimethyl amine benzoate (EDAB) as coinitiators were formulated. Scotchbond Multipurpose (SBMP) adhesive was used as commercial reference. All materials were analyzed for polymerization kinetics, flexural strength, elastic modulus, water sorption/solubility, shear bond strength to bovine enamel and dentin, characterization of hybrid layer by scanning electron microscopy (SEM), microbiological direct contact test, and cytotoxicity. Results The adhesive with PipM presented higher degree of conversion and lower sorption/solubility when compared with other groups. Shear bond strength to enamel and dentin were similar for PipM and EDAB materials. The percentage of cellular viability was close to 100% and similar in the experimental groups and the commercial reference. Conclusions PipM presented similar or superior performance to the tertiary amine used as control, representing a potential alternative coinitiator for photopolymerizable dental materials. Clinical significance PipM could be potentially useful in the formulations of adhesive systems with enhanced chemical properties, which could mean improvement in the longevity of composite resin restorations.

Introduction. Mineral Trioxide Aggregate (MTA) is a tricalcium-based silicate, dicalcium silicate matrix. Despite its good biologic properties, some clinicians still claim to have difficulties in handling MTA after its preparation due to its sandy consistency. The aim of the present study was to evaluate the physicochemical properties and cytotoxicity of MTA Repair HP (Angelus, Londrina, PR, Brazil) compared with MTA Angelus (Angelus, Londrina, PR, Brazil). Materials and Method. The properties assessed were particle size, setting time, flow, film thickness, radiopacity, water solubility, compressive strength, and cytotoxicity. Statistical analysis was performed considering p < 0.05 as statistically significant. Results. For radiopacity, water absorption and solubility MTA Repair HP were statistically similar to MTA Angelus. The MTA Angelus had statistically different film thickness values, higher than MTA Repair HP (p < 0.05). Besides, MTA Angelus showed a lower and statistically different compressive strength after 28 days than MTA Repair HP (p Conclusions. The MTA Repair HP presented similar cell viability, lower film thickness, higher flow, setting time, and compressive strength values after 28 days than MTA Angelus. In general, the MTA Repair HP presented physicochemical and biological properties similar to the MTA Angelus.

This study evaluate the effect of nanoparticles (Bi2O3 - bismuth oxide; YbF3 - ytterbium trifluoride; SiO2 - silicon dioxide) on radiopacity (R), translucency parameter (TP), degree of conversion (DC), bond strength to dentin (µTBS), and quality of the adhesive interface of experimental two-step, etch-and-rinse adhesive systems. The R was evaluated using an x-ray equipment. TP was verified in five replications and DC was performed in triplicate. The µTBS was evaluated in specimens stored in distilled water after 24 h, 6, 12 and 24 months. The bonded interfaces were qualitatively examined by scanning electron microscopy (SEM), and using x-ray energy dispersive spectroscopy (EDS) for elemental analysis. Data were statistically analyzed at α = 0.05. YbF3 resulted in statistically greater R when compared with all the other groups (p = 0.024), which did not differ from each other. Bi2O3 was the adhesive with lowest TP. For DC, the YbF3 and C showed similar results (p = 0.627). Similar µTBS was obtained between groups. The addition of nanoparticles affected the chemical-mechanical properties. The incorporation of YbF3 could be considered a promising approach for the development of radiopaque dental adhesives.

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).

Objectives The EDTMP (ethylenediamine-tetra-methylene phosphonate) is a molecule similar to EDTA (ethylenediamine-tetra-acetic acid), but with phosphonates, thereby presenting efficient chelating action and binding adequately to proteins, such as collagen. The objective of this study was to evaluate EDTMP as new etching solution to aid ion-releasing adhesive containing beta-tri-calcium phosphate (β-TCP) fillers used for intrarradicular dentin bonding. Materials and methods Thirty extracted single-rooted human teeth were prepared, and glass-fiber posts were adhesively luted with Scotchbond Multipurpose (SBMP, 3 M) adhesive after etching with 37% phosphoric acid for 15s, 15% EDTA or 15% EDTMP for 120s, and SBMP adhesive incorporated or not with β-TCP. RelyX ARC (3 M) was used as resin cement. The restored roots were cut horizontally in 1 mm-thick slabs and submitted to push-out bond strength test after 24h and 6 months of water storage. Interfacial silver nanoleakage was investigated in scanning electron microscopy. Micro-Raman spectroscopy was employed to track mineralization at the hybrid layer. Data were submitted to two-way ANOVA and Tukey’s test (p Results EDTMP without β-TCP achieved the overall highest bond strength in both storage times. The addition of β-TCP impaired the improvements of EDTMP. The presence of carbonated apatite (peak at 1090 cm-1) was found in EDTMP without β-TCP, thereby suggesting remineralization. Little silver impregnation was observed in general across groups. Conclusion: EDTMP could be an optimal alternative as root dentin etchant for luting glass-fiber posts with improvements in dentin bond stability.

SUMMARY This study investigated the stability of the optical properties of high-translucent shades of dental resin-based composites. Four commercial materials (Filtek Z350 XT, Opallis, Amelogen Plus, and IPS Empress Direct) and 14 non-Vita shades were tested. Disc-shaped specimens for each resin-based composite-shade combination (n=6) were evaluated at T0 (baseline), T1 (after 30 days of storage in water), and T2 (after 30 days of storage each in water and a coffee solution). Color measurements were performed according to the L′C′h′ color system. Translucency Parameter (TP) and CIEDE2000 color difference (ΔE00) were calculated. Data were statistically analyzed at α = 0.05. Baseline TP values varied from 43 ± 1 to 55 ± 1. Changes in TP at T1 varied from −3.0% (Opallis T-Neutral) to 4.2% (Amelogen Plus Trans Orange), with no major differences from T0. At T2, most resin-based composites showed significantly increased opacity, with changes varying between −15.0% (Empress Direct Trans 20) and −2.7% (Z350 XT Blue). However, the TP values were ≥40 throughout the study. Storage in water caused negligible color differences, with ΔE00 values at T1 ≤ 0.9 ± 0.6. At T2, all materials tested showed significant color difference, and ΔE00 ≥ 3.2 ± 0.2. The orange shades from Opallis and Amelogen Plus showed lower color variation than did the other shades. The most significant optical changes upon storage were detected in the hue and particularly the chroma color coordinate. In conclusion, the high-translucent resin-based composites showed large variability in the stability of their optical properties among the tested brands and different shades of the same material. Regardless of the storage condition, the tested resin-based composites retained their high-translucency character over time.

Objective A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. Material and Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma) statement. Searches were performed until December 2014 in six databases: MedLine (PubMed), Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI - Instituto Nacional de Propriedade Industrial) was screened in order to get an overview of Brazilian technological development in the dental materials field. Two reviewers independently analyzed the documents. Only studies and patents related to dental materials were included in this review. Data regarding the material category, dental specialty, number of documents and patents, filiation countries, and the number of citations were tabulated and analyzed in Microsoft Office Excel (Microsoft Corporation, Redmond, Washington, United States). Results A total of 115,806 studies and 53 patents were related to dental materials and were included in this review. Brazil had 8% affiliation in studies related to dental materials, and the majority of the papers published were related to dental implants (1,137 papers), synthetic resins (681 papers), dental cements (440 papers), dental alloys (392 papers) and dental adhesives (361 papers). The Brazilian technological development with patented dental materials was smaller than the scientific production. The most patented type of material was dental alloys (11 patents), followed by dental implants (8 patents) and composite resins (7 patents). Conclusions Dental materials science has had a substantial number of records, demonstrating an important presence in scientific and technological development of dentistry. In addition, it is important to approximate the relationship between academia and industry to expand the technological development in countries such as Brazil.

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.

The objective in this case report is to present a correction of excessive gingival exposure performed through periodontal esthetic surgery, using clinical crown lengthening and lip repositioning. The patient reported discomfort when smiling due to excessive gingival exposure, and clinical and photographic examinations of the patient showed vertical maxillary growth as the main diagnosis. In the digital smile design, the possibility of crown lengthening observed for teeth – upper left and right central incisors and upper left lateral incisor. A lip-repositioning procedure was also planned. An incision was performed at the mucogingival junction, and a parallel incision was realized at the top of the alveolar mucosa. Afterward, the incised gingival band was removed through vertical incisions in the planned border area. The muscular area was preserved. A simple suture was made, with the approach of the gingival margins around the surgical area. The crown-lengthening procedure was performed with the flapless technique. After 2-year follow-up, the periodontal esthetic surgery, comprising crown lengthening and lip repositioning, was noninvasive and can thus serve as an interesting alternative treatment for excessive exposure of the gingival smile, as it results in a harmonious and natural smile.

This study evaluated the three-year lifespan of the bond to dentin of experimental self-etch adhesives containing benzodioxole derivatives – 1,3-benzodioxole (BDO) and piperonyl alcohol (PA) – as co-initiator alternative to amines. Adhesive resins were formulated using Bis-GMA, TEGDMA, HEMA, camphorquinone and different co-initiators: BDO, PA or ethyl 4-dimethylamino benzoate (EDAB – amine). An experimental self-etch primer was used to complete the two-step, self-etch adhesive system. Clearfil SE Bond (CSE) was used as commercial reference. Bond strength to human dentin was assessed by microtensile bond strength (µTBS) test, and failure mode was classified. Morphology of the dentin bonding interface was assessed via scanning electron microscopy (SEM). Irrespective of the dental adhesives evaluated, µTBS was higher after 24 hours compared with that after 1.5 and 3 years (p ≤ 0.001). However, adhesives with BDO and PA as co-initiators showed significantly higher bond strength than the bonding resin with EDAB (p ≤ 0.002), independent of the time evaluated. The commercial adhesive CSE showed similar bond strength compared with the other groups (p ≥ 0.05). Mixed failures were mainly observed after 24 hours, while adhesive failures were more frequently observed after 1.5 and 3 years. No notable differences in homogeneity and continuity along the bonded interfaces were detected among the materials in the SEM analysis. In conclusion, benzodioxole derivatives are feasible alternative co-initiators to tertiary amine in camphorquinone-based self-etching dental adhesive formulations.

This study investigated the effect of different monomeric systems and inorganic fillers on the physical properties of experimental resin adhesives and on the immediate and 6-month bond strength to dentin. Two, 2-step self-etch adhesive systems were prepared: two primers (constituted of GDMA-P, ethanol, water, and HEMA or PEG(400)-UDMA) and two adhesives (constituted of Bis-GMA, TEGDMA, and HEMA or PEG(400)-UDMA). Next, the adhesives were allocated into three groups according to filler incorporated: unfilled (control), silica (SiO2), or ytterbium trifluoride (YbF3). Degree of conversion (DC, after 30 and 60 s of light-activation), water sorption (WS) and solubility (SL), and flexural strength (σ) and modulus (Ef) tests were performed for all adhesives. A microtensile bond strength (µTBS) test to dentin was evaluated after 24 h (immediate) and 6 months (6-month) of water storage using a universal testing machine (DL500, EMIC). Data were analyzed using statistical tests (α=5%). The adhesives showed similar DC at a same light exposure time, although light-activation for 60 s improved conversion of monomers. The unfilled HEMA-containing adhesive showed higher WS, SL, σ and Ef compared to others. The incorporation of fillers into the adhesives did not affect negatively the immediate µTBS results; however, after 6 months the presence of SiO2 impaired in complete premature failures, and the presence of YbF3 reduced the µTBS in the PEG(400)-UDMA-based group. The unfilled HEMA-containing group also reduced bond strength after 6 months of water storage. In conclusion, depending on the resin matrix composition, YbF3 seems to be a good option for reinforcing adhesive systems.

SUMMARY Objective: The esthetics of the smile are related to the color, shape, texture, dental alignment, gingival contour, and the relationship of these with the face. Purpose: To present a two-year follow-up for an esthetic rehabilitation clinical case in which the method of digital smile design (DSD) was used to assist and improve diagnosis, communication, and predictability of treatment through an esthetic analysis of the assembly: face, smile, periodontal tissue, and teeth. Clinical Procedure: The smile's esthetics were improved through gingival recontouring, dental home bleaching, and a restorative procedure with thin porcelain laminate veneers using lithium disilicate glass-ceramic (e.max Ceram, Ivoclar-Vivadent) laminates on teeth 4 through 13. Discussion: The proposed technique had an acceptable clinical performance at the end of a two-year follow-up. Significance: DSD can be used to increase professional/patient communication and to provide greater predictability for the smile's esthetic rehabilitation.