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The aim of this study was to observed the anesthetic efficacy of the alveolar nerve block on nine patients that CBCT diagnosed unilateral retromolar canal on a double-blind, split-mouth approach. The assessments of patient response to thermal (pulp vitality test) and pressure (compression of soft tissue) stimuli were carried out before and 5 minutes after the inferior alveolar nerve block procedure, using both visual analog scale (VAS) and Mc Gill pain questionnaires (McG). The mean percentage of patient response decreased after alveolar nerve block, according to both VAS and McG, and was statistically similar among hemi mandibles with and without retromolar canal (Wilcoxon>0.05); however, those without retromolar canal presented greater reduction in patient response in 6 out of 9 cases. Therefore, the retromolar canal is not a determinant factor of inferior alveolar nerve block failure. Resumen El objetivo de este estudio fue observar la eficacia anestésica del bloqueo del nervio alveolar en nueve pacientes que CBCT diagnosticó canal retromolar unilateral en un abordaje de boca dividida doble ciego. Las evaluaciones de la respuesta del paciente a los estímulos térmicos (prueba de vitalidad pulpar) y de presión (compresión de los tejidos blandos) se realizaron antes y 5 minutos después del procedimiento de bloqueo del nervio alveolar inferior, utilizando tanto la escala analógica visual (VAS) como los cuestionarios de dolor de Mc Gill ( McG). El porcentaje medio de respuesta de los pacientes disminuyó tras el bloqueo del nervio alveolar, según EVA y McG, y fue estadísticamente similar entre hemimandíbulas con y sin canal retromolar (Wilcoxon>0,05); sin embargo, aquellos sin canal retromolar presentaron mayor reducción en la respuesta del paciente en 6 de 9 casos. Por lo tanto, el canal retromolar no es un factor determinante del fracaso del bloqueo del nervio alveolar inferior.

Objetivo. El objetivo de este estudio fue evaluar la adaptación marginal de coronas de disilicato de litio obtenidas mediante técnicas de escaneo (CAD/CAM), antes y después de la cristalización, a través de análisis in vitro con microscopía confocal (MC). Métodos. Fueron confeccionadas 16 réplicas en poliuretano a partir de la pieza 1.4, de modelo typodont, tallada para corona total. Las réplicas fueron divididas en dos grupos, de acuerdo a la técnica de escaneo: Técnica Indirecta (Grupo IND, n=08), donde modelos de yeso fueron escaneados con escáner de laboratorio (inEos X5, Sirona Dental Systems) y Técnica Directa (Grupo DIR, n=08), donde modelos typodont fueron escaneados con escáner intraoral (CEREC BlueCam, Sirona Dental Systems). A seguir, se fresaron (inLab MC XL, Sirona Dental Systems) coronas en disilicato de litio (IPS e.max CAD, Ivoclar Vivadent) y se adaptaron a las réplicas. Se evaluó la adaptación marginal con análisis de MC en dos momentos, antes y después de la cristalización del disilicato de litio. Los datos fueron analizados con la prueba de Mann-Whitney, t de Student y Wilcoxon (α= 0,05). Resultados. Hubo una diferencia estadísticamente significativa en la adaptación marginal horizontal entre los grupos IND y DIR después de la cristalización (p=0,05). En el grupo IND, la comparación de la adaptación marginal vertical antes y después de la cristalización mostró una diferencia estadísticamente significativa (p=0,038). Conclusiones. Las coronas de disilicato de litio obtenidas mediante escaneo directo (CAD/CAM) presentaron menor desajuste marginal vertical. La etapa de cristalización afectó la adaptación marginal de las coronas.

to evaluate trueness and precision of digital casts from intraoral scanning (IOS) and cone beam computed tomography (CBCT); trueness and precision of 3D-printed casts using digital light processing (DLP) and fused deposition modeling (FDM); the influence of digitizing method in the 3D-printed casts and, to compare STL data after DICOM segmentation and conversion.a reference cast was digitized with IOS and CBCT, and 3D-printed using FDM and DLP. Linear measurements of occlusocervical (OC), interarch (IEA), and mesiodistal (MD) dimensions were taken on reference, digital and 3D-printed casts. Trueness was observed as the distortion, and precision was observed as the variation of measurements. One and Two-way ANOVA, Student t-test, and Chi-Square were applied to analyze data.distortion varied between digital casts for all dimensions; at OC, both showed expanded dimensions with IOS being significantly greater; in turn, CBCT digital casts showed higher distortion at IEA and MD. Dimensions of 3D-printed casts showed a predominance of shrinkage, DLP presented higher distortion compared to FDM for both digitizing methods. Digitizing methods influenced the 3D-printing of casts, especially for DLP. Regarding precision, no statistical difference was found. STL converted from DICOM showed statistical difference in IEA (p 0.001).digital casts showed distortion depending on the digitizing method. IOS was better in IEA and MD, and CBCT in OC dimensions. Overall, DLP casts presented higher distortion compared to FDM. The digitizing method influences trueness on 3D-printed casts. File conversion from DICOM to STL per se could change the dimension.This investigation showed that digital casts from IOS and CBCT as well 3D-printed casts from FDM and DLP can show different trueness. It is clinically relevant as clinicians have various workflows available in Digital Dentistry which involve these digitizing and manufacturing methods.

Objetivo: Este estudo coletou e analisou dados clínicos referentes ao reparo de restaurações dentais em pacientes atendidos nas clínicas de uma Faculdade de Odontologia ao longo de 10 anos. Materiais e Métodos: Dados relacionados ao procedimento de reparo em restaurações de dentes permanentes foram extraídos do sistema de prontuários eletrônicos da Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, e analisados de acordo com o período (2008 - 2017), faixa etária (< 30, 30 - 60,> 60), grupo dental e faces dentais. Estatística descritiva (frequência absoluta e relativa), e teste do Qui-Quadrado (95% de confiança), foram usados para comparar a frequência de reparos em restaurações dentais entre cada ano, faixa etária, grupo dental e face dentária. Resultados: Reparos em restaurações de dentes permanentes foram identificados em 1.408 de 48.915 prontuários. Os reparos em restaurações dentais aumentaram durante o período avaliado mostrando significância estatística em 2016 e 2017; foram mais frequentes em indivíduos com idade entre 30 e 60 anos e menos frequentes nos caninos e nas faces dentais incisal e lingual. Conclusão: O número de reparos em restaurações dentais aumentou ao longo do período estudado. Houve diferenças significantes na comparação entre os anos do estudo (2008 a 2017), faixa etária (< 30, 30 - 60, > 60), grupo dental e faces dentais. Objective: This study collected and analyzed clinical data regarding the repair of dental restorations in patients treated in the clinics of a dental school over 10 years. Material and Methods: Data related to repair procedures for permanent tooth restorations were extracted from the digital dental records system and filtered according to year (2008 - 2018), age (< 30, 30 - 60, > 60), tooth group and dental faces. Data were analyzed with descriptive statistics in terms of the absolute and relative frequency, and Chi-Square test (95% confidence) were used to compare the frequency of repairs between years, age, tooth and dental faces. Results: A total of 48.915 dental records were accessed by searching for general restorative procedures, of which 1408 were repairs of dental restorations on permanent teeth. The number of repairs per year increased over the period assessed and there was a significant increase in the years 2016 and 2017. Individuals aged between 30 and 60 years received the largest number of repairs, with significantly more repairs than the other groups. Regarding the tooth group and face, the canines and the incisal and lingual dental faces received the least number of repairs. Conclusion: The number of repairs increased over the study period (2008 to 2017). When comparing frequencies between groups, those belonging to 30 to 60 years of age received more repairs, and the least repaired teeth was the canines and the lingual and incisal faces.

Objective This study investigated whether a sample of anterior resin composite restorations could be differently evaluated in different centers of evaluation by clinical and lay evaluators. Methods Anterior resin composite restorations on high-quality intraoral digital photography were evaluated using FDI criteria (1-5 score) by pairs of clinical and lay evaluators in Brazil (BR), France (FR), Peru (PE), and the United States of America (USA). Scores were allocated as maintenance (1, 2, 3), repair (4) and replacement (5) when comparing clinical evaluators and, as acceptable (1, 2, 3) and unacceptable (4, 5) when comparing clinical vs. lay evaluators and lay vs. lay evaluators. The Chi-square test compared the frequencies of scores among the centers. Results The frequencies of maintaining, repairing, or replacing anterior resin composite restorations given by clinical evaluators varied depending on the evaluation center. BR and PE showed the highest frequencies for repair and replacement, while FR and USA showed the highest frequencies for maintenance. The comparison of frequencies of anterior resin composite restorations accepted or unaccepted by the clinical vs lay evaluators in the same centers showed a significantly higher frequency of acceptable dental restorations coming from clinical evaluators. Comparison between lay evaluators from different centers showed significant higher frequency of unacceptable dental restorations by BR, compared to other centers. Conclusions In the evaluation of anterior resin composite restorations, the maintenance, repair, or replacement trends can vary among different centers. The unacceptable rate came more frequently from lay than from clinical evaluators. Lay evaluators from different centers differed significantly. Clinical Significance Clinical and lay evaluators in distant evaluation centers can present different trends when assessing anterior resin composite restoration. Multicenter evaluations can help to understand such differences and it is important because clinical decision-making based on scientific evidence comes from clinical studies done in different research centers.

Objectives: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs). Methods: Sets of panoramic (PAN) – cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations. Results: Percentage agreement and McNemar test compared PAN vs CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN vs CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with p < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images. Conclusions: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.

O objetivo desse estudo foi avaliar in vitro, a ação dos lasers de alta potência (Nd:YAG e diodo 980nm), associados ao carvão mineral como fotopotencializador, sobre a adesividade do cimento endodôntico, por meio do teste de pushout, e na interface dentina/material obturador, por meio de microscopia confocal a laser. 50 caninos foram instrumentados com sistema Mtwo até #50.04 e irrigados com hipoclorito a 1% a cada troca dos instrumentos. Os espécimes foram distribuídos em 5 grupos (n=10): GI - controle EDTAC, GII - EDTAC e laser Nd:YAG, GIII - EDTAC e laser diodo 980 nm, GIV - EDTAC, laser Nd:YAG e carvão mineral 5 g/100mL, e GV - EDTAC, laser diodo 980 nm e carvão mineral 5 g/100 mL. As aplicações de laser foram na potência de 1.5 W, frequência de 100 Hz pulsátil e fibra de 200μm, por 16 segundos em movimentos elípticos (8 s no sentido coroa-ápice e 8 s no sentido ápice-coroa). Após, os espécimes foram obturados com cimento AH Plus, pela técnica de condensação lateral ativa. As raízes foram seccionadas no sentido transversal, em slices de 1mm de espessura, e submetidas ao teste de pushout em máquina universal de ensaios e o tipo de falha foi analisado em microscópio confocal a laser, e se determinou a profundidade e a uniformidade dos tags de cimento na interface dentina/material obturador. Os dados foram analisados por meio do teste ANOVA a nível de significância de 5%, seguidos dos testes de Kruskal-Wallis, Dunn e Tukey (para a comparação dos grupos). O GI apresentou a maior a resistência de união do cimento à dentina que o tratamento somente com EDTAC 17% (17,21 ± 21,75 MPa), sendo semelhante ao GII (12,21 ± 18,20 MPa) e ao GIV (14,92 ± 28,06 MPa), ambos tratados com laser Nd:YAG, com exceção do GIV, que foi adicionado de carvão mineral. O GV (8,75 ± 13,42 MPa) apresentou resultados similares aos dos grupos GII e GIV, mas a mesma similaridade foi observada quando comparado ao GIII (7,11 + 11,28 MPa), que apresentou os piores resultados. O terço apical (23,27 ± 29,21 MPa) apresentou valor de resistência de união maior que o cervical (5,92 ± 5,33 MPa) e médio (6,93 ± 7,11MPa), que foram semelhantes entre si (p>0,05). Houve predominância de falhas mistas, seguidas das coesivas. O GII (86,27µm) apresentou os maiores valores de penetração de tags, com diferença estatisticamente significante em relação aos GIII (51,57µm), IV (36,77µm) e V (32,37µm) (p0,05). O GIV apresentou os menores valores, sem diferenças do III e V, (p>0,05). O terço cervical (58,44µm) apresentou os melhores valores, seguidos dos terços médio (45,02µm) e apical (42,24µm) (p>0,05). Concluiu-se que o tratamento com laser Nd:YAG associado ou não ao carvão mineral, apresentou melhores resultados de força adesiva que o tratamento com laser diodo 980nm, exceto quando esse foi adicionado do carvão mineral. O grupo controle e o laser diodo 980nm apresentaram menores quantidades de falhas adesivas e maiores quantidades de falhas mistas comparados aos demais grupos. Ambos os lasers não interferiram de maneira negativa na penetração de cimento se comparados ao grupo controle, no que se relaciona à resistência adesiva do cimento obturador. The aim of this study was to evaluate in vitro the influence of high-power lasers (Nd:YAG and diode 980nm) associated with mineral coal as fotopotencializer on Bond strenght of an epoxy resin-based root canal sealer to root dentin, using the push-out test, and on the dentin/filling material interface, using confocal laser microscopy. For this purposes, 50 canines were instrumented with Mtwo Rotary system up to #50.04 instrument, irrigating with sodium hypoclorite 1% at each instrument exchange. The specimens were randomly assigned to 5 groups (n=10), according the treatment of root canal dentin: group I - control EDTAC, group II - EDTAC and Nd:YAG laser, group III - EDTAC and diode laser 980 nm, group IV - EDTAC, Nd:YAG laser and mineral coal 5 g/100 mL, and group V - EDTAC, diode laser 980 nm and mineral coal 5 g/100 mL. All the lasers application was assigned according to the parameters: 1.5 W of power, 100 Hz pulsatile frequency and 200 µm fiber, for 16 seconds in eliptical movements (8 s crown-down direction and 8 s apex-crown direction). Following irradiation, the canals were filled with active lateral condensation of AH Plus sealer and gutta-percha cones. After, the roots were sectioned transversally to obtain 1mm-thick slices. One of two slices from each third were subjected to a push-out test in a universal testing machine and the failure mode was analyzed with confocal laser microscopy and classified as: adhesive to the filling material, adhesive to dentin, cohesive in the filling material and mixed. The remaining slice was analyzed by confocal laser microscopy to evaluate the penetration and homogeneity of the perimeter of the root canal cross-section with sealer tags, at the dentin/filling material interface. All data were analyzed by ANOVA (at 5% significance level) following the Kruskal-Wallis, Dunn and Tukey tests (for groups comparation). Any of the proposing treatments increased more Bond strength of the sealer to root dentin that treatment with only EDTAC 17% (17.21 ± 21.75 MPa), similar to the group II (12.21 ± 18.20 MPa) and group IV (14.92 ± 28.06 MPa), both treated with Nd: YAG laser, with the exception of group IV, which was added to mineral coal. The group V (8.75 ± 13.42 MPa) had similar results to the groups II and IV, but the same similiarity were found when compared with group III (7.11 + 11.28 MPa), with lower results. Regarding the root thirds, the apical third (23.27 ± 29.21 MPa) presented a statistically higher value on Bond strenght than the cervical third (5.92 ± 5.33 MPa) and middle third (6.93 ± 7, 11 MPa) (p> 0.05). It was observed in general that there was a predominance of mixed failures, followed by cohesive failures. The lowest amount were the adhesive failures. Group II (86.27µm) showed the highest tags penetration values, with a statistically difference to the group III (51.57 µm), IV (36.77 µm) and V (32.37 µm) (p < 0.05). Group I (71.63 µm) was statistically similar to groups II and III (p> 0.05). Group IV had the lowest values and was statistically similarity to groups III and V (p> 0.05). The cervical third (58.44 µm) showed best values, followed by the middle third (45.02mm) and apical third (42.24 µm) (p> 0.05). It was concluded that the treatment with Nd:YAG laser provides better results than the diode 980 nm laser, except when was added mineral coal. The control and diode 980 nm laser groups presented less adhesive failures and more mists failures than the other groups. Both lasers did not interfere negatively compared to the control group