Brazilian Dental Science

Assessment of Dual Rinse Combined with Sodium Hypochlorite Irrigating Solution on Post-Instrumentation Pain and Bacterial Load Reduction: A Randomized Clinical Trial

Laila Zakaria Ismail Abdel-Hamid — 2024-10-01

Objective: The study compared the efficacy of Dual Rinse combined with sodium hypochlorite in comparison to sodium hypochlorite irrigating solution on post instrumentation pain incidence, reduction of the load of intracanal bacteria and periapical MMP-9 expression in patients with pulp necrosis. Material and Methods: Thirty-four patients diagnosed with a necrotic mandibular premolar having a single root canal were included. Following confirmation of the diagnosis, patients were randomly allocated into one of two groups of 17 patients each (intervention group; Dual Rinse + 2.5% NaOCl, control group; 2.5% NaOCl irrigation). Standard endodontic treatment was done in two visits. Post-instrumentation pain was assessed at 6, 12, 24 hours and 48 hours using Heft-parker visual analogue scale (Heft parker VAS). The intracanal bacterial levels assessed pre- and postinstrumentation through counting of CFU/mL. Periapical MMP-9 levels were assessed post-instrumentation and pre-obturation by ELISA. All data collected from patients was statistically analyzed. Results: Regarding postinstrumentation pain incidence, there was no statistically significant difference detected among tested irrigants at all time intervals (p>0.05). There was a significant reduction in the count of intracanal bacterial in both groups after instrumentation, but without any significant difference between tested irrigants (p>0.05). Within a week, there was a considerable drop in the periapical MMP-9 levels without any discernible differences between the two irriagnts (p>0.05). Conclusion: The addition of Dual Rinse to 2.5% NaOCl solution did not result in any apparent increase in the incidence of post-instrumentation pain or in periapical MMP-9 levels. Both irrigating solutions were almost equally successful in lowering the amount of bacteria in primary infected root canals while maintaining the antibacterial activity of the NaOCl.

KEYWORDS

Bacterial load reduction; Dual rinse in sodium hypochlorite; Irrigation; Matrix metalloproteinase (MMP-9); Post-instrumentation pain.

Evaluation of Flexural Strength and Degree of Conversion of Temporary Crown Materials at Different Ageing Periods in Artificial saliva

Huda Abbas Abdullah — 2024-12-19

Objective: Evaluate the effects of different storage periods on flexural strength (FS) and degree of conversion (DC) of four bis-acryl resin provisional restorative materials. Materials and method: A total of 60 specimens were prepared from four temporary crown materials available commercially, and assigned into the four tested groups (n = 15): Group A (Prevision Temp), Group B (B&E CROWN), Group C (Primma art), and Group D (Charm temp). The specimens were stored in artificial saliva, and FS was tested after 24 h, 7 d, and 14 d. A standard three-point bending test was conducted using a universal testing machine. Additionally, the DC was determined using a Fourier-transform infrared spectroscopy (FTIR) device. The data were statistically analyzed by two-way ANOVA, Tukey HSD multiple comparison, and Bonferroni test at a significance level of 5 %. For each group, Paired Samples Test was applied to cmpare the DC of immediate and 24 h. Results: The highest FS value was found for Prevision Temp material, while the Charm Temp material showed the lowest FS, with no statisttiCal significant difference between the mean values of the groups at 24 h, while there were significant differences at 7 and 14 d of storage. Prevision Temp had the highest mean DC value, which was significantly different from other materials. Conclusion: Prevision Temp showed higher FS and DC than the other tested materials. The FS of provisional restorative materials is not significantly influenced by storage at first 24 h.

Shade match, marginal adaptation and patient satisfaction: polymer infiltrated ceramic versus lithium disilicate glass ceramic anterior laminate veneers (Randomized Clinical Trial)

Nancy Sayed Abdel Aziz Abdel All Khalil — 2024-12-19

Objective: To evaluate the shade match, marginal adaptation and patient satisfaction of VITA ENAMIC multiColor anterior laminate veneers and compare it to that of IPS e.max CAD. Material and Methods: A total of twenty-two laminate veneers were fabricated from IPS e.max CAD and VITA ENAMIC multiColor in the anterior zone, eleven veneers for each group. The patients were randomly divided into two equal groups according to the restorative material. Group EX (control group) eleven IPS e.max CAD veneers and Group EMC (intervention group) eleven VITA ENAMIC multiColor veneers. Shade match and marginal adaptation was assessed using modified USPHS criteria and patient satisfaction was evaluated through visual analogue scale (VAS), immediately after cementation. Data were analyzed using CHI- square test. P 0.05 was considered statistically significant. Results: The results showed that there was no statistically significant difference between the two groups in terms of shade matching, marginal adaptation and patient satisfaction. Conclusion: IPS e.max CAD and VITA ENAMIC multiColor veneers provided a successful clinical performance in terms of shade match, marginal adaptation and patient satisfaction.

KEYWORDS

CAD-CAM; Ceramics; Color perception; Hybrid; Lithium disilicate.

Volumetric measurement of sleep bruxism-like indentations on acrylic surface using intraoral scanner and inlay wax

Thaviporn Limrachtamorn — 2024-12-19

This in vitro study introduced methods to measure the volume of sleep bruxism-like indentations to be used in the evaluation of bruxing intensity. Indentations of different sizes and depths were created on seven clear heat-cured acrylic blocks. The volume of all indentations was first measured by a profilometer as the gold standard, then by scanning the negative replicate of the indentations obtained from polyvinyl siloxane impressions both with double impression technique (IOSD) and putty silicone only (IOSP), using an intraoral scanner, and lastly by weighing the blue inlay wax used to fill the indentation. Agreements between the intraoral scanning and blue inlay wax methods compared to the profilometer were tested using ICC. The results showed that ICCs between IOSD, IOSP, inlay wax and the profilometer were 0.963, 0.950, and 0.999 respectively. The average volumetric error tended to be greater with IOSD (30.518.34 %) and IOSP (35.6810.29 %) compared to that of blue inlay wax (24.8710.29 %). Blue inlay wax was apparently superior to IOSD and IOSP in quantifying small and deep indentations. Both intraoral scanner and blue inlay wax had high agreement in volumetric measurement of acrylic indentations while the wax method performed the best. These methods could be used to measure the amount of wear on occlusal splints.

Pattern of palatal rugae for forensic identification in Peruvians from the Puno region

Yessica Quilca Soto — 2024-12-19

Introduction: Recent studies present rugoscopy as a useful tool in forensic identification, since the pattern of palatal wrinkles does not change during the course of life and is resistant to decomposition, trauma and fire. Objective: To identify the patterns of palatal wrinkles that predominate among patients attending the Viadent Dental Clinic in the Puno region and to assess their usefulness as a reliable method for gender identification and recognition. Methods: Observational, descriptive and cross-sectional research in a sample of 108 study models in plaster cast type III of the upper jaw of individuals treated for orthodontics, on which calcorugoscopy was performed and the shape and number of palatal rugae were described, according to Silva's classification. The results were processed by ANOVA and discriminant analysis. Results: A total of 1509 palatal rugaes were analyzed, with a statistically significant pattern in which 28.8%, 25.8% and 22.3% prevalence of straight, wavy and curved rugaes were observed, respectively, with the same tendency in both sexes. A 97 % accuracy in individual identification was achieved, although gender was not discriminated. Conclusions: The uniqueness and individuality of the pattern of palatal rugaes is confirmed, so that rugoscopy can be considered as a reliable, simple, fast and low-cost alternative or complementary method for human identification in the field of forensic dentistry in Peru.

Evaluation of union resistance of a three-step conventional adhesive system modified by BETA-TCP particles

Stéphanny Maria Meira — 2024-12-19

Objective: This study aimed to evaluate the bond strength and fracture pattern of a three-step dentin adhesive system, Scotch Bond Multipurpose (SBMP) (3M ESPE), with or without beta-tricalcium phosphate (beta-TCP) particles added to the primer solution. Materials and Methods: Twelve human molar teeth were used, each sectioned perpendicularly into dentin discs. These discs were randomly allocated into three groups: G1 (control), G2 (primer modified with beta-TCP 0.5%), and G3 (primer modified with beta -TCP 2%). Each group consisted of four discs for testing. The dentin discs were treated according to the adhesive system protocol. After storage in distilled water, the discs were treated with 35% phosphoric acid gel, the primer (modified or not), and SBMP adhesive, followed by light-curing (Valo Ultradent). Twenty-four hours later, each restored dentin disc was sectioned to obtain specimens for tensile strength testing. Fracture pattern analysis was performed using scanning electron microscopy (SEM). Results: Statistical analysis of the tensile strength results showed no significant difference between the control and modified adhesive systems. The fracture pattern observed using SEM was predominantly mixed. Conclusion: The addition of beta-TCP particles to the adhesive primer solution did not affect bond strength or the fracture pattern.

Keywords

Dentin adhesives. Beta Particles. MEV. Tensile strength. Tooth Remineralization.

Association between painful temporomandibular disorders and psychosocial factors in dental students

Fernando Ortiz-Culca — 2024-12-19

Objective: To establish the association between painful Temporomandibular Disorders (TMD) and psychosocial factors in dental students, using the Diagnostic Criteria for TMD. Material and Methods: This cross-sectional study included dental students of the Universidad Nacional Mayor de San Marcos from the third to tenth cycle. Descriptive and inferential statistical tests were used, including the chi- square, Fisher’s, and t-tests, and multivariate analysis to analyze the results. Results: This study was carried out on 203 students aged 17–48 years; 64.5% were female. Using the TMD pain screener, we found 14.7% and 15.76% of painful TMD in the short and long versions, respectively. Painful TMD was associated with chronic pain (odds ratio [OR: 34.506 and 9.205 for the short and long versions, respectively), moderate depression (OR: 7.545 and 6.301 for the short and long versions, respectively), severe depression (OR: 57.218 and 18.310 for the short and long versions, respectively), and oral habits (OR: 3.146 for the long version). Conclusion: Psychosocial variables may increase the risk for the presence of painful TMD. Moderate and severe depression and oral habits were significantly associated with TMD pain.

KEYWORDS

Chronic pain; Cross-sectional studies; Dental students; Psychology; Temporomandibular joint disorders.

Impact of gray background on tooth color shade matching: a comparison of visual and instrumental methods

Walleska Feijó Liberato — 2024-12-19

Objective: This study evaluates the impact of a gray background on visual tooth shade selection, focusing on
various incisal translucency patterns in upper incisors. Material and Methods: Sixty-three clinicians assessed
VITA 3D Master Shade Guide tabs representing right upper central incisors under different conditions, with or
without a gray background. Translucency patterns (A, B, C) were considered, and standard tabs were defined
using a clinical spectrophotometer. Statistical analyses, including repeated measures ANOVA and ordinal logistic
regression, compared scores and agreement levels. Results: Darker tabs were selected for Case C, while Case B
resulted in lighter tabs. A gray background increased lightness levels, enhancing agreement between visual and
instrumental shade selection. Reduced agreements were noted in cervical areas and cases with higher incisal
translucency. No significant difference was found among tooth thirds (P=.097). Conclusion: Using a gray
background during tooth shade selection improved agreement between visual and instrumental shade selection.
Incorporating this method can enhance tooth shade matching when relying on visual analysis. Introducing a
cost-effective gray background can significantly improve agreement between visual and instrumental shade
selection, addressing financial constraints associated with advanced tools. Clinicians can now implement a more
reliable and accessible protocol, positively impacting the precision of esthetic restorations, especially in cases
involving upper incisors.
KEYWORDS
Color; Color perception; Dental shade; Operative dentistry; Shade selection.

The Er.Cr.YSGG Laser's impact in the occlusion of dentinal tubules: in vitro study

Mohammed Ziad Tarik — 2024-12-20

Aim of the study: To assess how well the Er.Cr.YSGG laser seals dentinal tubules when it's used on exposed dentine. Severe discomfort due to exposed dentin that is brought on by thermal, tactile, evaporative, electrical, osmotic, or chemical stimulation is known as dentinal hypersensitivity. It typically includes the teeth's facial surfaces close to the cervical boundary and, typically, in premolars and canines. It might be caused by either cemental or enamel loss. Method: Twenty-nine natural posterior teeth were prepared, sectioned, cleaned, and made ready for treatment. Samples were split into groups: Group A, the group under negative control (N = 10), and Group B: Er.Cr.YSGG (Waterlase, I plus, Biolase Technology, Irvine, CA) was administered (N = 10) along with a pilot research group (N = 9). Wavelength of 2780 nm, irradiation mode is free-running pulse, power of 0.25 W, frequency of 20 Hz, pulse width of 60 µs, time of 2 seconds, Fiber tip size: 600 µm, non-contact mode, power density of 83.33 W/cm² with 0% water and 0% air, fiber tip fixed on a distance of 1 mm perpendicular to the dentin surface with a clamp holder. Scanning electron microscopy (SEM) was used to analyze dentin-obstructed surfaces. A qualitative evaluation of the micrographs was conducted to analyze the shift in surface features. Data analysis was performed using (spss) software (version 26, IBM,USA) to investigate the data's normal distribution. The Kolmogorov-Smirnov and Shapiro-Wilk tests revealed that the data had an abnormal distribution. Mann-Whitney U test was carried out to show a comparison between groups (control, laser group). Results: The data obtained from the laser group showed a large reduction in tubular diameter (0.737 µm) as compared to the control group (3.095 µm). The selected parameters (0.25W/2s, 83.33 W/cm²) were best to reduce and plug any exposed dentinal tubules without any indication of fissures or cracks. Conclusion: The study conclusively demonstrates that Er:Cr:YSGG laser irradiation offers a viable solution for dentin hypersensitivity by partially or completely occluding dentin tubules. Future clinical trials are warranted to further explore its efficacy.

Keywords: Dentinal tubules, Er.Cr.YSGG, Hypersensitivity, Laser, Teeth sensitivity.

Morphological analysis of the bristles from toothbrushes sold in the Peruvian market, using scanning electron microscopy

Pablo Alonso Lopez Beraun — 2024-12-20

Objective: To analyze, using scanning electron microscopy, the morphological characteristics of the bristle filaments of toothbrushes marketed in Peru. Materials and Methods: Images obtained through scanning electron microscopy of 23 adult toothbrushes with nylon bristles (621 bristles) were used, and the morphology of their filament tips was evaluated using the Silverstone and Featherstone classification modified by Reiter and Wetzel and classified as Acceptable or Non-acceptable. Results: Of the bristles evaluated, 169 (27.2%) were classified as acceptable, while 452 (72.8%) were non-acceptable. Among the toothbrushes analyzed, four exhibited more than 50% acceptable bristles, including one with 100% acceptability. Conversely, another four brushes displayed 100% non-acceptable bristles. Conclusions: The results demonstrate a high frequency of non-acceptable bristles, with a ratio 2.5 times greater than the acceptable ones. This variability indicates a lack of uniformity in manufacturing standards across brands, emphasizing the urgency to implement stricter regulations to ensure the quality and safety of these crucial oral hygiene instruments.

Keywords: Oral Self-Care Devices, Personal Hygiene Products, Dental and Oral Hygiene Products, Toothbrushing, Oral Hygiene (MeSH)

Biocompatibility and Bioactive Potential of New Bioceramic Sealers in Rat Bone Tissue: Histological Analysis

Marcus Victor Vaz Soares Castro — 2024-12-20

Objective: Sealer Plus BC and Bio-C Sealer are new silicate-based sealers. We aimed to evaluate the biocompatibility and bioactivity of these silicate-based endodontic sealers compared to that of AH Plus epoxy resin sealer. Materials and Methods: Fifteen rats underwent a surgical procedure to create a cavity in the tibial bone, where the sealer was inserted according to the group. The animals were euthanized after postoperative period of 15 days. Histological analysis was made, and the results were scored according to the signs of repair, quality of the bone tissue, and presence of inflammation. ANOVA Kruskal-Wallis and Mann-Whitney tests (p <0.05) were performed. Results: Sealer Plus BC showed neoformation or presence of bone tissue in 73.33% of samples. Bio-C Sealer showed connective tissue in differentiation or presence of bone in 66.66%. AH Plus showed 80% (p = 0.01) of the samples with granulated tissue in the bone defect. Sealer Plus BC presented 46.66% of samples with absence of inflammatory cells and Bio-C Sealer showed moderate inflammatory process in 66.66% (p = 0.02). Conclusions: The two silicate-based sealers presented better biocompatibility and bioactivity compared to AH Plus epoxy resin sealer.

Keywords

Animal Model; Calcium Silicate; Endontics; Endodontic Obturation; Material Testing.

Utilizing Texture Analysis technique in diagnostic imaging at Dentistry: Innovations and Applications

Victória Geisa Brito de Oliveira — 2024-12-19

Background: The Texture Analysis (TA) technique allows the evaluation of intrinsic properties by extracting signal patterns from pixels and voxels in images that are unnoticed by the human eye. In medical imaging, TA has been applied to the characterization of various lesions. In Dentistry, in recent years, we have observed the application of this tool in various specialties. Objective: This short communication aims to present the applications of the texture analysis (TA) technique in Dentistry and its possibilities for the coming years. For this brief review, the search was conducted in the Pubmed, LILACS, and Google Scholar databases, using the descriptors “Computer-Assisted Image Processing”, “Diagnostic Imaging” and Dentistry”. Were included articles that addressed the topic, published in the last 5 years in English, and compatible with the present theme. Considering the 22 articles found, it was observed that, for the most part, AT applications aim to assist in the diagnosis of lesions of the maxillofacial complex. Then temporomandibular disorders and oral manifestations of autoimmune conditions. There are also applications in orthodontics, periodontics, implant dentistry, and cariology. Conclusion: The TA technique presents itself as a promising method within dental imaging, since, through its mathematical and quantitative tools, it provides greater accuracy and objectivity. In this way, we can see the emergence of a biomarker that assists professionals in the early diagnosis of injuries. However, the research carried out to date has limitations, and more studies are needed to understand the capabilities of TA.

Keywords:

Dentistry; Imaging Diagnosis; Dentistry; Computer Aided Image Processing; Radiomics.

Effect of bisphosphonate use on orthodontic tooth movement: A Systematic Review

Gurgiane Rodrigues Gurgel Lessa — 2024-12-19

Statement of problem: As bisphosphonates have an action mode which interferes in the osteo-resorptive process, their use during dental treatment may occasionally have side effects, such as: inhibition of tooth movement, delayed bone healing, and osteonecrosis in the maxilla and mandible. Objective: The present study proposed a systematic review of the literature on the effect of systemic use of bisphosphonates on orthodontic tooth movement. Methods: This systematic review was developed based on PRISMA guidelines and recommendations and included scientific articles published until september 2023. The question raised was: “Does the systemic use of bisphosphonates interefere in orthodontic movement?” Results: We initially identified 51 articles in the electronic search. This number was then reduced to 13 publications after the analysis of titles and abstracts. Conclusion: Most studies of this systematic review point to the fact that the systemic use of bisphosphonates during orthodontic treatment seems to reduce the extent and speed of tooth movement, thus extending the treatment duration.

Evaluation of Monomer Conversion, Vickers Hardness, Compressive Strength & Water Sorption of Commercial Dental Composite Resins

Saadia Bano Lone — 2024-12-19

Treatment of peri-implant mucosal fenestration with m-VISTA technique– a 2-year follow-up case report

Gustavo Macedo Pereira — 2024-12-19

The modified VISTA technique (modified Vestibular Incision Subperiosteal Tunnel Access) has been introduced as a minimally invasive approach for the treatment of gingival recessions. This technique could also be applied to managing peri-implant soft tissue defects (PSTD). This case report presents a 2-year follow-up case in which the m-VISTA technique was used in the treatment of a class 1A PSTD. A 66-year-old female patient complained of food accumulation and a non-aesthetic aspect in the peri-implant buccal region of tooth 11. On clinical examination, there was a peri-implant soft tissue defect, with a recession and fenestration of the buccal mucosa. A Cone Beam Computed Tomography (CBCT) was requested to complement the diagnosis, and a buccal bone defect was observed. Before the surgical phase, basic peri-implant therapy was performed. In surgery, the m-VISTA technique was used, seeking the slightest trauma to the soft tissues around the defect, especially the mucosal margin. The patient returned for suture removal after 14 days. Follow-ups were carried out in the first 14 and 21 days, 2 months, 6 months, and 1 and 2 years after surgery. After two years, there was a complete closure of the peri-implant mucosal fenestration and complete coverage of peri-implant soft tissue recession. This 2-year follow-up case report showed the m-VISTA technique could be a successful approach in the treatment of a peri-implant mucosal fenestration and recession.

Keywords

Case Report; Dental implantation; Gingival recession; Oral Surgery; Periodontics.