Abstract Objective: This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015. Methods: This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis. Results: Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged > 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death. Conclusion: Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.

Resumo Objetivo: Esse estudo avaliou a mortalidade materna (MM) e fatores relacionados em um município de grande porte da região sudeste do Brasil (Campinas, São Paulo) no período de 2000-2015. Métodos: Esse estudo consistiu de duas fases: 1. Uma fase analítica de caso-controle que avaliou o impacto de variáveis individuais e contextuais na MM; 2. Uma fase ecológica delineada para contextualizar as mortes maternas por meio de análise espacial. O grupo caso consistiu de 87 mortes maternas e o grupo controle de 348 mulheres que tiveram bebês durante o mesmo período. Os dados foram analisados por estatística descritiva, testes de associação e regressão logística múltipla (RLM) (p < 0,05) assim como análise espacial. Resultados: A taxa de mortalidade materna foi de 37 mortes para cada 100.000 nascidos vivos. As mortes foram dispersas por todo o território urbano e não se observou formação de clusters. Na RLM observou-se que mulheres grávidas com idade > 35 anos (OR = 2,63) ou aquelas que passaram por cesárea (OR = 2,51) foram mais propensas à morte materna. Conclusão: As mortes maternas foram distribuídas dispersamente entre os diferentes níveis socioeconômicos e mais propensas a ocorrer entre mulheres > 35 anos de idade ou que passaram por cesárea.

Abstract To evaluate the feasibility of using a milled polyetheretherketone (PEEK) post and core in endodontically treated teeth with or without a ferrule. Sixty bovine tooth roots were endodontically treated followed by cementation of intraradicular retainers (IR), according to each experimental group: a) non-ferrule glass fiber post (f0FP); b) 2-mm-ferrule glass fiber post (f2FP); c) non-ferrule resized glass fiber post (f0PR); d) 2-mm-ferrule resized glass fiber post (f2PR); e) non-ferrule PEEK post and core (f0PPC); and f) 2-mm-ferrule PEEK post and core (f2PPC). Metal crowns were made and cemented. A periodontal ligament was simulated using polyether. A force was applied to the palatine portion of each sample at 45°, until fracture. Fracture resistance data were submitted to two-way ANOVA and Tukey’s test (α = 0.05). Three-dimensional digital models were developed to calculate the tensions formed in the root using finite element analysis. Models of glass fiber posts and PEEK posts and cores were evaluated with or without a ferrule. The results were analyzed by the Mohr-Coulomb criterion. The type of IR was not influenced by fracture strength (p = 0.243). There were significant statistical differences among the remaining factors. Ferrule groups had greater fracture resistance, and the failure mode of teeth with a ferrule was more catastrophic than the non-ferrule group. A ferrule increases fracture resistance and influences failure mode; the PEEK post and core did not modify the biomechanics of endodontically treated teeth, and resembled the glass fiber post results. The crack initiation point differed between the ferrule and non-ferrule groups.

Abstract This study aimed to evaluate the effect of endodontic sealer (ES) on bond strength (BS) of prefabricated or milled-CAD-CAM (computer-aided design and computer-aided manufacturing) glass-fiber-posts (GFP). Canals of 90 single-rooted teeth were prepared for filling by the single-cone technique with gutta-percha and one of the following ES: AH Plus (epoxy resin), Endofill (zinc-oxide and eugenol), and Bio-C Sealer (calcium-silicate). After post-space preparation, tooth-specimens were equally divided in half according to type of GFP to be used. In the half to receive milled-CAD-CAM posts, tooth specimens were molded with acrylic resin to obtain replicas. These were scanned to enable the laboratory to produce the milled-CAD-CAM GFPs (Fiber CAD Lab, Angelus) by the subtractive technique. The other half of samples received prefabricated GFPs (Exacto, Angelus) (n=15). The GFPs were cemented with dual-cure resin cement (Panavia F2.0, Kuraray). Each root was sectioned into two slices per root region (cervical, middle, apical) that were subjected to the push-out BS test, in a universal testing machine. Failure mode (FM) was classified by scores. The BS data were submitted to generalized linear model analyses, while FM was analyzed using the chi-square test (a=0.05). BS showed no significant difference among the three ES (p > 0.05). BS was significantly higher for prefabricated (mean 10.84 MPa) versus milled-CAD-CAM GFPs (mean 6.94 MPa) (p <0.0001), irrespective of ES. The majority showed mixed failures. It could be concluded that type of ES did not affect BS of GFPs to dentin, and prefabricated-GFPs had higher bond-strength than customized-milled-CAD-CAM GFPs.

Aim To evaluate dentin permeability after pretreatment with 2.5% aqueous solution of titanium tetrafluoride (TiF4), followed by a self-etching universal adhesive system. Methods Forty dentin discs (1.5 mm thick) were randomly divided into groups according to the application or non-application of a pretreatment, and the type of adhesive system to be tested (two-step self-etching/ Clearfil SE Bond/ Kuraray Medical, or universal adhesive system/ Single Bond Universal/ 3M ESPE). Both sides of the discs were conditioned with 37% phosphoric acid to remove the smear layer. The first hydraulic conductivity measurement (L1) was performed in a permeability machine, under 5 PSI pressure. The samples were sanded again to form a standardized smear layer. The teeth designated for pre-treatment with TiF4 received the TiF4 solutions applied actively for 60 seconds, and the adhesive systems were applied according to the manufacturer’s instructions. Then, a new hydraulic conductivity measurement (L2) was performed for the purpose of calculating the hydraulic conductance at a later time, considering the water viscosity and the thickness of the specimen. The percentage (L) of dentin permeability after application of the adhesive system was obtained (L (%) = [(L1-L2) x100] / L1). The Mann-Whitney non-parametric test was applied. Results There was no difference between the two adhesive systems, or between the groups with or without pretreatment, as regards dentin permeability (p>0.05). Conclusion Pretreatment with 2.5% TiF4 did not influence dentin permeability, irrespective of the adhesive system used.

ABSTRACT Aim To evaluate the occlusal and internal marginal adaptation of inlay restorations made of different materials, using CAD-CAM. Methods Preparations were made for MOD inlays of one-third intercuspal width and 4 mm depth in 30 third human molars. The teeth were restored using CAD-CAM materials (n=10) of nanoceramic resin (Lava Ultimate), polymer-infiltrated ceramic network (VITA ENAMIC), or lithium disilicate glass-ceramic (IPS e.max CAD). The specimens were cemented with dual resin cement and sectioned at the center of the restoration, after which the two halves were evaluated, and photographed The occlusal and internal discrepancy (µm) was determined at five points: cavosurface angle of the occlusal-facial wall (CA-O); center of the facial wall (FW); faciopulpal angle (FPA); center of the pulpal wall (PW); and center of the lingual wall (LW). The data were submitted to the Kruskal-Wallis and the Dunn tests (α=0.05). Results No difference was observed among the materials regarding the occlusal discrepancy at the CA-O, FPA, or PW internal points. The e.max CAD measurement at FW showed larger internal discrepancy than that of Lava (p=0.02). The internal discrepancy at LW was greater for e.max CAD than VITA ENAMIC (p=0.02). Conclusion Lithium disilicate glass-ceramic presented greater internal discrepancy in relation to the surrounding walls of the inlay preparations.

RESUMO Objetivo: O objetivo deste estudo foi comparar métodos para diagnóstico in vitro de sulcos pigmentados em superfície oclusal. Métodos: Foram utilizados 41 molares e pré-molares humanos extraídos com pigmentação em sulcos e fissuras. Os dentes foram avaliados com iluminação artificial para classificação quanto ao critério ICDAS, seguida por avaliação com laser fluorescente. Para a avaliação radiográfica, os dentes foram posicionados para obtenção de imagens interproximais, adotando-se o critério de Rodrigues et al. (2008) para diagnóstico. Para avaliação histológica, os dentes foram seccionados no sentido mésio-distal na região de sulco oclusal e avaliados em lupa estereoscópica com aumento de 20 vezes, adotando-se o critério de Ekstrand et al. (1997). Os métodos foram comparados com a avaliação histológica, obtendo-se valores de acurácia, sensibilidade e especificidade quanto às variáveis de resposta “presença/ausência” de lesão de cárie em esmalte. Resultados: Ao comparar a inspeção visual com a análise histológica, observou-se acurácia de 65,85%, sensibilidade de 40% e especificidade de 90,48%. Ao comparar o laser fluorescente com a análise histológica, a acurácia foi de 58,54%, sensibilidade de 70% e especificidade de 47,62%. Na comparação da análise radiográfica com a histológica, obteve-se acurácia de 53,66%, sensibilidade de 42,11% e especificidade de 73,68%. Conclusão: A curva ROC mostrou que a inspeção visual apresentou a melhor combinação de sensibilidade e especificidade que o laser fluorescente e que a análise radiográfica para o diagnóstico, representando o melhor método para detecção de cárie em lesões com sulcos pigmentados em esmalte

ABSTRACT Objective: The aim of this study was to compare methods for in vitro diagnosis of pigmented pits and fissures on the occlusal surface. Methods: Forty-one human molars and premolars extracted with pigmentation in pits and fissures were used. The teeth were evaluated with artificial illumination for classification according to ICDAS, followed by fluorescent laser evaluation. For the radiographic evaluation, the teeth were positioned to obtain interproximal images, adopting the criterion of Rodrigues et al. 2008 for diagnosis of lesions. For histological evaluation, the teeth were sectioned in the mesiodistal direction in the occlusal sulcus region and evaluated in a 20-fold stereoscopic magnifying glass, using the criterion of Ekstrand et al. (1997) for evaluation. The methods were compared with the histological evaluation, obtaining values of accuracy, sensitivity and specificity regarding the response variables “presence / absence” of enamel caries. Results: When comparing visual inspection with histological analysis, 65.85% accuracy, 40% sensitivity and 90.48% specificity were observed with false positive and negative probability of 20% and 38.71%. When comparing the fluorescent laser with the histological analysis, the accuracy was 58.54%, sensitivity 70% and specificity 47.62%. Comparing the radiographic analysis with the histological analysis, it was obtained 53.66% accuracy, sensitivity of 42.11% and specificity of 73.68%. Conclusion: The ROC curve and the Yuden index showed that visual inspection presented the best combination of sensitivity and specificity than fluorescent laser and radiographic analysis for diagnosis, which represented the best method for detecting inactive carious lesions in enamel.

Resumo Introdução as resinas compostas são indicadas para reconstrução de paredes proximais e a avaliação das propriedades das resinas compostas bulk-fill flow expostas ao desafio ácido mostra-se necessária. Objetivo avaliar a microdureza e rugosidade em diferentes profundidades de fotoativação de resinas compostas bulk-fill flow (Filtek Bulk Fill Flow; SureFil SDR Flow; Tetric N Ceram Bulk fill) e convencional (controle, Filtek Z350 XT) submetidas ao desafio ácido. Material e método quarenta amostras retangulares (3x3x4 mm) foram confeccionadas utilizando uma matriz de poliacetal. Para simular o desafio ácido, as amostras foram imersas em uma solução desmineralizante. Cada amostra teve a microdureza Knoop (KHN) e rugosidade (Ra) avaliadas em três profundidades (superficial, média e cervical), considerando a superfície lateral da amostra. Os dados foram submetidos aos testes de Kruskal-Wallis, Friedman e Dunn com nível de significância de 5%. Resultado comparando as resinas compostas entre si, nas regiões superficial (p=0,693), média (p=0,053) e cervical (p=0,176), não houve diferença nos valores de KHN. Também não houve diferenças na rugosidade entre os materiais nas regiões superficial (p=0,356), média (p=0,734) e cervical (p=0,207). Apenas o Filtek Z350 XT (p=0,027) apresentou menor diferença de KHN na região intermediária causada pelo desafio ácido. As mudanças na rugosidade mostraram que a maior diferença foi na região cervical para Bulk Fill Flow SDR (p=0,014) e Tetric N-Ceram Bulk Fill (p=0,003), com aumento após o desafio ácido. Conclusão após desafio ácido, as resinas compostas bulk-fill flow apresentaram alterações semelhantes às apresentadas pela resina composta convencional nanoparticulada.

Abstract Introduction composite resins are indicated to the reconstruction of proximal walls and the evaluation of properties of flow bulk-fill composite resins exposed to acid challenge is necessary. Objective to evaluate the microhardness and roughness at different depths of photoactivation of bulk-fill flow composites (Filtek Bulk Fill Flow; SureFil SDR Flow; Tetric N Ceram Bulk fill) and conventional composite resin (control, Filtek Z350 XT) subjected to acid challenge. Material and method forty composites brick shaped specimens (3x3x4 mm) were made using a polyacetal matrix. To simulate pH challenges, the samples were immersed in a demineralizing solution. Each sample had Knoop microhardness (KHN) and roughness (Ra) evaluated at three depths (superficial, medium, and cervical), considering the lateral surface of the sample. Data were submitted to Kruskal-Wallis, Friedman's and Dunn's tests with a significance level of 5%. Result comparing the composites among themselves, in superficial (p=0.693), medium (p=0.053) and cervical (p=0.176) regions, there was no difference in the KHN values. There were also no differences in roughness between the composites in superficial (p=0.356), medium (p=0.734) and cervical (p=0.207) regions. Only the Filtek Z350 XT (p=0.027) showed less difference in KHN in the middle region caused by acid challenge. Changes in roughness showed that the greatest difference was at the cervical region for Bulk Fill Flow SDR (p=0.014) and Tetric N-Ceram Bulk Fill (p = 0.003) with an increase after acid challenge. Conclusion after acid challenge, bulk-fill flow composites showed alterations similar to those presented by the conventional nanoparticulate resin composite.

RESUMO A retomada às atividades odontológicas em tempos de pandemia tem sido um desafio devido à geração e dispersão de gotículas e aerossóis que podem conter o vírus SARS-CoV-2, agente etiológico da covid-19. Nos últimos meses algumas estratégias de contenção de gotículas e aerossóis tem circulado pela internet, mas a eficácia destas barreiras ainda não apresenta um bom nível de evidência na Literatura. Desta forma, e utilizando um modelo de dispersão microbiana, o objetivo deste estudo preliminar foi comparar a dispersão da alta rotação (AR) sem ou associada a uma barreira individual de biossegurança odontológica (AR / BIBO) que consiste em um bastidor acoplado ao filme de PVC e TNT. A turbina da alta rotação foi ativada durante um minuto em uma solução de Lactobacillus casei Shirota, a qual havia sido previamente acrescentada no reservatório de refrigeração de um equipamento odontológico, e placas de petri contendo ágar MRS foram posicionadas a partir do apoio de cabeça de uma cadeira odontológica nas distâncias de 50, 100 e 150 cm em diferentes ângulos (90 e 0 graus). Na distância de 50 cm, a média (desvio padrão) de L. casei Shirota para AR foi de 13.554,59 (493,48) UFC, enquanto a associação AR/BIBO foi de 570,67 (60,54) UFC, estabelecendo uma redução de 96% (p<0,0001). Considerando estes resultados preliminares e o modelo de estudo utilizado, a barreira individual de biossegurança odontológica se mostrou eficiente em reduzir a dispersão da turbina de alta rotação, o que sugere que o seu uso pode ser uma alternativa para a melhoria da biossegurança em ambiente odontológico.

ABSTRACT The return to dental practice in pandemic times is a new challenge due to the generation and dispersion of droplets and aerosols that may contain the SARS-CoV-2 virus, the etiological agent of covid-19. In the last months some droplet and aerosol containment strategies have been circulating on the internet, however, until now there is no evidence in the literature to prove the effectiveness of such barriers. Thus, using a microbial dispersion model with the fast handpiece, the aim of this preliminary study was to compare the dispersion caused by the the dental drill (DD) alone or in association with an individual biosafety barrier (IDBD / DD), which consisted of a layer of PVC film combined to a layer of polypropylene mounted on a frame. The dental drill was activated for one minute having had the water from the reservoir been replaced with a suspension of Lactobacillus casei Shirota. Petri dishes containing MRS agar were positioned at 50, 100 and 150 cm from the headboard of the dental chair at different angles (90 and 0 degrees). At 50 cm, the mean (standard deviation) of L. casei Shirota for DD was 13,554.59 (493.48) CFU, while for IDBD / DD was 570.67 (60.54) CFU (p <0.0001), establishing a 96% reduction. Considering these preliminary results, the individual biosafety barrier proved effective in reducing dispersion from the dental drill in this study model, which suggests that this barrier may be a viable option to optimize biosafety in the dental environment.

Abstract Titanium dioxide nanotubes are nanostructures that can accelerate the oxidation reaction of bleaching procedures and promote a more effective whitening effect. Objective This study evaluated physicochemical properties of bleaching agents incorporated with titanium dioxide (TiO2) nanotubes, and the effects on tooth color change at different periods. Methodology 40 premolars were treated according to the following groups (n=10): CP - 10% carbamide peroxide (1 hour daily/21 days); CPN - CP incorporated into TiO2; HP - 40% hydrogen peroxide (three 40-minute sessions/7 days apart); HPN - HP incorporated into TiO2. Color shade was evaluated at five different periods (baseline, after 7, 14 and 21 days of bleaching, and 7 days after end of treatment) according to Vita Classical, CIELab and CIEDE2000 scales. Mean particle size (P), polydispersity (PO) and zeta potential (ZP) were evaluated using dynamic light scattering. Data on the different variables were analyzed by mixed model tests for measures repeated in time (ZP e L*), generalized linear models for measures repeated in time (P, PO, Vita Classical and b*), and Friedman and Mann-Whitney tests (a* and color change/ΔE and ΔE00). Results CP and CPN presented higher P, higher PO and lower ZP than HP and HPN (p≤0.05). All groups showed a significant decrease in Vita Classical color scores after 7 days of bleaching (p<0.05), and HPN presented a greater significant reduction than the other groups. L* increased in TiO2 presence, in all groups, without any differences (p>0.05) in bleaching time. A significant reduction occurred in the a* and b* values for all the groups, and HPN presented lower a* and b* values (p<0.05) than CPN. ΔE was clinically noticeable after 7 days, in all groups, and all groups resulted in a perceptible color change according to ΔE00. Conclusion TiO2 did not influence physicochemical properties of the bleaching agents. HPN presented more effective tooth bleaching than CPN.

Abstract The aim of this in vitro study was to evaluate the color stability of a bulk-fill (Filtek One Bulk Fill, 3M ESPE) and a conventional (Filtek Z350 XT, 3M ESPE) composite resin light-cured at different distances, before and after being submitted to staining with a coffee solution. Sixty specimens of each composite resin were prepared and light-cured at distances of 0, 2 and 4 mm, using a LED light-curing unit (Valo, Ultradent). The specimens were separated (n = 10) for immersion in either distilled water or coffee solution (10 minutes a day for 8 days) to stimulate staining. Color evaluations were performed before and after immersion in the solutions, according to CIELab (△Eab), CIEDE2000 (△E00) and the Whiteness Index for Dentistry (△WID). Kruskal Wallis and Dunn tests, Mann-Whitney tests and Wilcoxon test were applied (α = 5 %). The a* value for conventional composite resin showed a significant increase after immersion in coffee and distilled water (p < 0.05). Both composite resins showed greater b* values when immersed in coffee than in distilled water, with no significant difference among the light-activation distances (p > 0.05). There was no significant difference for L* among the light-activation distances; both resins showed significant decrease in L* after immersion in coffee (p < 0.05). Color change (△Eab, △E00) and difference in whiteness (△WID) were higher for conventional resin when immersed in the coffee solution at all the light-activation distances. Conventional composite resin presented a higher staining value than bulk-fill composite resin, regardless of the light-activation distance.

Resumo Objetivo: este estudo investigou o efeito das condições de lubrificação no atrito entre braquetes e fios de NiTi de diferentes secções transversais. Métodos: os braquetes (Roth, GAC) foram fixados a um dispositivo conectado a uma máquina de ensaio universal, que recebeu segmentos de fio de NiTi (Nitinol, GAC) com secções de 0,012”; 0,016” ou 0,020”. Após o fio ter sido instalado no slot do braquete, aplicou-se um dos seguintes lubrificantes: saliva humana (SH: controle positivo), água destilada (AD) ou saliva artificial à base de mucina (MUC) ou de carboximetilcelulose (CMC). No grupo controle negativo, nenhum lubrificante foi utilizado. As combinações entre as secções dos fios e as condições de lubrificação geraram 15 grupos, com 15 amostras cada. Os dados foram submetidos à análise de variância a dois critérios e ao teste de Tukey. Resultados: não houve interação significativa entre a secção do fio e a condição de lubrificação (p = 0,901). Independentemente de ter sido utilizado ou não lubrificante, observou-se elevação significativa do atrito com o aumento da secção transversal do fio (p < 0,001). Para qualquer um dos fios, o grupo testado na presença de MUC não diferiu daquele em que se aplicou SH. Por outro lado, quando suprimiu-se os lubrificantes, constatou-se atrito significativamente mais elevado. Os grupos CMC e AD demonstraram comportamento intermediário. Conclusões: o atrito se elevou com o aumento da secção transversal dos fios de NiTi, mas a despeito do fio, o atrito com a saliva à base de MUC foi similar àquele com a SH e menor do que sob condição a seco.

Abstract Objective: This study investigated the effect of the condition of lubrication on the friction between brackets and NiTi archwires of different rounded cross-sections. Methods: Brackets (Roth, GAC) were affixed to a device connected to a universal testing machine into which segments of archwire were placed (NiTi, Nitinol, GAC) with cross-sections of 0.012-in, 0.016-in and 0.020-in. Once the wire was in the bracket slot, the following lubricants were applied: human saliva (HS: positive control), distilled water (DI), mucin-based (MUC) or carboxymethylcellulose-based (CMC) artificial saliva. In the negative control group, no lubricant was used. The combination between the wire cross-sections and the lubrication condition generated 15 groups with 15 samples each. Data were submitted to two-way analysis of variance and Tukey’s test. Results: There was no significant interaction between the wire cross-section and the condition of lubrication (p= 0.901). Irrespective of whether lubricants were used or not, there was a significant increase in friction with an increase in the cross-section of the wire (p< 0.001). For any wire, the group tested in the presence of MUC was not different from that in which HS was applied. On the other hand, when the application of lubricants was suppressed, significantly higher friction values were observed. The CMC group and the DI group demonstrated intermediate behavior. Conclusions: Friction increased with the increase of the cross-section of the NiTi archwire, but regardless of the archwire, friction with MUC artificial saliva was similar to that of HS and lower than in dry conditions.

Abstract: The aim of this study was to evaluate soluble and insoluble fluoride concentrations in commercial varnishes, and their remineralization effect on artificial caries enamel lesions using surface and cross-sectional microhardness evaluations. Forty bovine enamel blocks were separated into four groups (n=10): control (no treatment), Enamelast (Ultradent Products), Duraphat (Colgate-Palmolive) and Clinpro White Varnish (3M ESPE). Surface enamel microhardness evaluations were obtained, artificial enamel caries lesions were developed by dynamic pH-cycling, and the varnishes were then applied every 6 days, after which the enamel blocks were submitted to dynamic remineralization by pH cycles. After removal of the varnishes, the enamel surfaces were reassessed for microhardness. The blocks were sectioned longitudinally, and cross-sectional microhardness measurements were performed at different surface depths (up to 300 μm depth). Polarized light microscopy images (PLMI) were made to analyze subsurface caries lesions. The fluoride concentration in whole (soluble and insoluble fluoride) and centrifuged (soluble fluoride) varnishes was determined using an extraction method with acetone. The data were analyzed to evaluate the surface microhardness, making adjustments for generalized linear models. There was a significant decrease in enamel surface microhardness after performing all the treatments (p<0.0001). Enamelast and Duraphat showed significantly higher enamel microhardness values than the control and the Clinpro groups (p = 0.0002). Microhardness loss percentage was significantly lower for Enamelast (p = 0.071; One-way ANOVA). PLMI showed that subsurface caries lesions were not remineralized with the varnish treatments. No significant differences in the in-depth microhardness levels (p = 0.7536; ANOVA) were observed among the treatments. Enamelast presented higher soluble and insoluble fluoride concentrations than the other varnishes (p < 0.0001; Kruskal-Wallis and Dunn tests). Enamelast and Duraphat varnishes promoted enamel surface remineralization, but no varnish remineralized the subsurface lesion body. Although insoluble and soluble fluoride concentration values did not correspond to those declared by the manufacturer, Enamelast presented higher fluoride concentration than the others.

Resumo Introdução Cimentos resinosos autoadesivos não necessitam de tratamento prévio da superfície dental, por esta razão o pré tratamento da dentina pode influenciar a longevidade da resistência adesiva. Objetivo Avaliar a influência do tratamento dentinário com etanol (ET) 100% e clorexidina (CL) 2% na resistência de união (RU) de um cimento resinoso autoadesivo (CRA) à dentina intrarradicular. Material e método 80 raízes bovinas restauradas com pino de fibra de vidro e CRA (U200 3M/ESPE) foram distribuídas em 4 grupos, de acordo com o tratamento prévio da dentina intrarradicular: Grupo 1 – nenhum tratamento; Grupo 2 – CL2% por 1 minuto; Grupo 3 – ET100% por 1 minuto; Grupo 4 – CL2% seguido pelo ET100%. As amostras foram seccionadas no sentido radial para obtenção de duas secções de aproximadamente 0,7 mm de espessura em cada terço – cervical, médio e apical. Após 48 horas e 180 dias foi realizado o teste push-out. Resultado A ANOVA a três critérios para blocos casualizados demostrou que não houve diferença entre os valores de resistência de união nos tempos 48 h e 180 dias, independentemente do tratamento e do terço (p>0,05). A interação tratamento-terço foi significativa (p = 0,041) sendo que o tratamento com CL promoveu menor RU no terço cervical e o tratamento com ET promoveu melhor RU no terço apical. Conclusão Os tratamentos com CL e ET individualmente ou associados não promoveram diferenças entre os valores de RU do CRA à dentina intrarradicular ao longo do tempo.

Abstract Introduction Self-adhesive resin cements do not require prior preparation of the tooth surface, therefore dentin pretreatments may influence long-term bond strength. Objective To evaluate the influence of 100% ethanol (ET) and 2% chlorhexidine (CL) treatment of intraradicular dentin on the long-term bond strength (BS) of a self-adhesive resin cement (SRC). Material and method 80 bovine roots were restored with fiber posts and SRC (U200 3M/ESPE) and distributed into 4 groups according to dentin treatment: Group 1 – without treatment; Group 2 – 2% CL for 1 minute; Group 3 – 100% ET for 1 minute; Group 4 – 2% CL, followed by 100% ET. The samples were cross-sectioned to obtain two sections (0.7 mm) thick for each root third: coronal, middle and apical. The immediate push-out test was carried out after 48 hours, and the long-term push-out test, after 180 days. Result The three-way ANOVA test for randomized blocks showed no difference between the BS values at 48 hours and 80 days, irrespective of the treatment and the third (p>0.05). The interaction of the treatment/third pairing was significant (p = 0.041) since the treatment with CL promoted lower BS in the coronal third, while treatment with ET promoted better BS in the apical third. Conclusion Treatment with CL and ET, separately or combined, promoted no differences between the BS values of the SRC to root dentin over time.

RESUMO As restaurações de resinas compostas têm aumentado consideravelmente em popularidade e previsibilidade, possibilitando a realização de um tratamento odontológico minimamente invasivo. No entanto, para se obter o sucesso das restaurações de resina composta é necessário ter conhecimento dos materiais adesivos e da técnica de utilização, caso contrário os insucessos podem aparecer rapidamente. Assim, o objetivo deste trabalho foi realizar uma revisão de literatura sobre o desempenho clínico de diferentes tipos de resinas compostas e de sistemas adesivos no que se refere à longevidade. Para essa avaliação foram verificadas algumas características das restaurações logo após elas serem finalizadas e depois de um determinado tempo. Características como sensibilidade pós-operatória, cor, integridade marginal, cárie secundária, textura, adaptação marginal, retenção, deslocamento, descoloração marginal, forma anatômica, tiveram seus desempenhos comparados. A influência dos vários sistemas adesivos na longevidade das restaurações foi também observada em função da sua fundamental importância na união entre o dente e o material restaurador. Concluiu-se que a maioria das restaurações se apresentou clinicamente aceitável, quando se usou resinas compostas híbridas, nanoparticuladas ou microhíbridas e sistema adesivo convencional.

ABSTRACT Composite resin restorations have increased considerably in popularity and predictability, enabling the realization of a minimally invasive dental treatment. However, to obtain the success of composite resin restorations, knowledge of adhesives and the use of the technique are required, otherwise failure may appear quickly. The objective of the present work was to conduct a literature review on the clinical performance of different types of composite resins and adhesive systems with regard to longevity. For this evaluation, some characteristics of the restorations were immediately verified after they were completed and after a determined time. Characteristics such as postoperative sensitivity, color, marginal integrity, secondary caries, texture, marginal adaptation, retention, displacement, marginal discoloration and anatomical shape had their performances compared. The influence of different adhesive systems on the longevity of the restorations was also observed as a function of its fundamental importance in the union between the tooth and the restorative material. It was concluded that most restorations performed clinically acceptable when hybrid, nanoparticle or microhybrid composite resins and conventional adhesive systems were used.

RESUMO Objetivo Avaliar a resistência de união por cisalhamento (RU) de uma cerâmica de dissilicato de lítio (CDL) à zircônia (Y-TZP) utilizando diferentes estratégias de cimentação. Métodos Cilindros de CDL foram cimentados à estrutura de Y-TZP de acordo com os seguintes sistemas adesivos (SA)/ Cimentos resinosos (CR) (n=15): U: CR autoadesivo de cura dual; AMBAR: SA contendo monômeros fosfatados (MF) + CR convencional de cura dual; SBU: SA contendo MF/silano + RC de cura fotoativada; ALLB: SA contendo MF/silano + CR de cura dual. Os corpos de prova foram submetidos ao teste de cisalhamento em máquina universal de ensaios (0.5 mm/min). Os dados (MPa) foram submetidos a ANOVA a um critério e teste de Tukey (α = 0,05). Resultados Observou-se que os grupos SBU e ALLB promoveram valores de RU estatisticamente superiores ao grupo U, no qual observou-se a menor média de RU. Para o grupo AMBAR, valores de RU intermediários foram encontrados, os quais não diferiram dos demais grupos. Conclusão Independente do cimento resinoso, o uso de sistemas adesivos contendo monômeros fosfatados em sua composição promoveram resistência de união superior ao cimento resinoso autoadesivo.

ABSTRACT Objective This study evaluated the shear bond strength (SBS) of lithium disilicate glass (LDG) ceramic bonded to a zirconia (Y-TZP), using different cementation strategies. Methods LDG ceramic cylinders were cemented to Y-TZP structure according to the following adhesive system (AS)/resin cement (RC) (n = 15): U- self-adhesive dual-cure RC; AMBAR- AS containing phosphate monomers (PM) + dual-cure RC; group SBU: PM+Silane/AS + light-cure RC; group ALLB: PM/AS + dual-cure RC. Specimens were subjected to SBS in a universal testing machine (0.5 mm/min). Data (MPa) were subjected to one-way ANOVA and Tukey's test (α = 0,05). Results The groups SBU and ALLB had significantly higher SBS than those provided by the group U, in which the lowest values were observed. For the AMBAR group, intermediate SBS values were found, which did not differ significantly from the values observed in the other groups. Conclusion Regardless of resins cement, the use of adhesives containing phosphate monomers provided superior bond strength than self-adhesive cement.