Abstract This study compared the pH and calcium ion release of calcium silicate- (Bio-C Temp) and calcium hydroxide-based (Ultracal XS) medications. Intracanal remnants of both medications were also evaluated using SEM-EDS after the removal protocol. Thirty-five bovine teeth were prepared. Fifteen were filled with Bio-C Temp and 15 with Ultracal XS. Five remained without intracanal medication (control group). Five samples from each experimental time (i.e.. 24, 72, and 168 hours) were used to measure pH and calcium ions release using a digital pH meter and microplate reader, respectively. Afterward, the peaks of the chemical elements composing both medications were analyzed in SEM-EDS. One-way ANOVA and Tukey's post hoc test analyzed the pH and calcium ion release data. Student's t-test compared the medications in each experimental time. SEM-EDS described the percentage of chemical elements in the samples. Bio-C Temp and Ultracal XS showed a significant pH increase from 24 to 168 hours (p<0.05). Ultracal XS showed a higher pH value at 24 hours than Bio-C Temp (p<0.05) but were similar at 72 and 168h (p > 0.05). Calcium ion release did not depend on the experimental period (p > 0.05). Bio-C Temp showed lower calcium ions release than Ultracal XS at 24 hours (p<0.05). SEM-EDS analyses showed the remains of both medications, but the concentration of Si, Al, and W ions was present only in the calcium silicate-based medication. Bio-C Temp presented alkaline pH and a satisfactory calcium ion release over the time. The remaining of both medications were present after the protocols for paste removal.

Resumo Este estudo comparou o pH e a liberação de íons cálcio de medicações intracanais a à base de silicato de cálcio (Bio-C Temp) e à base de hidróxido de cálcio (Ultracal XS). Remanescentes de ambas as medicações também foram avaliados usando microscopia eletrônica de varredura e espectroscopia de dispersão de energia após o protocolo de remoção. Trinta e cinco dentes bovinos foram preparados. Quinze dentes foram preenchidos com Bio-C Temp e 15 com Ultracal XS. Cinco permaneceram sem medicação intracanal (grupo controle). Cinco amostras de cada tempo experimental (ou seja, 24, 72 e 168 horas) foram usadas para medir o pH e a liberação de íons de cálcio usando um medidor de pH digital e um leitor de microplacas, respectivamente. Em seguida, os picos dos elementos químicos que compõem os dois medicamentos foram analisados em microscopia eletrônica de varredura e por espectroscopia de dispersão de energia. Os testes One-way ANOVA e post hoc de Tukey analisaram os dados de pH e liberação de íons cálcio. O teste t de Student comparou as medicações em cada tempo experimental. A microscopia eletrônica de varredura e a espectroscopia de dispersão de energia descreveu a porcentagem de elementos químicos nas amostras. O Bio-C Temp e o Ultracal XS mostraram um aumento significativo de pH de 24 a 168 horas (p<0,05). O Ultracal XS apresentou um valor de pH mais alto em 24 horas do que o Bio-C Temp (p<0,05), mas foi semelhante em 72 e 168h (p > 0,05). A liberação de íons cálcio não dependeu do período experimental (p> 0,05). O Bio-C Temp apresentou menor liberação de íons de cálcio do que Ultracal XS em 24 horas (p<0,05). As análises de microscopia eletrônica de varredura e espectroscopia de dispersão de energia mostraram remanescentes de ambas as medicações, mas a concentração de íons Si, Al e W estavam presentes apenas na medicação à base de silicato de cálcio. O Bio-C Temp apresentou pH alcalino e maior liberação de íons cálcio. Remanescentes de ambas as medicações estiveram presentes após os protocolos de remoção da pasta.

Abstract This study aimed to evaluate the effect of antioxidant solutions on fracture strength and bonding performance in non-vital and bleached (38% hydrogen peroxide) teeth. One hundred and eighty dentin specimens were obtained, 60 for each test: fracture strength, hybrid layer thickness, and bond strength. The groups (n=10) were randomly composed according to post-bleaching protocol: REST - restoration, without bleaching; BL - bleaching + restoration; SA - bleaching, 10% sodium ascorbate solution, and restoration; AT - bleaching, 10% α-tocopherol solution, and restoration; CRAN - bleaching, 5% cranberry solution, and restoration; CAP - bleaching, 0.0025% capsaicin solution, and restoration. Data were analyzed with ANOVA, Kruskal-Wallis, Dunn, and Qui-Square tests (α=0.05). The highest fracture strength values were observed in REST (1508.96 ±148.15 N), without significant difference for the bleached groups (p>0.05), regardless of the antioxidant use. The hybrid layer thickness in the group that was not subjected to bleaching (REST) was significantly higher than in any other group. The bond strength in the bleached and antioxidants-treated groups (SA, AT, CRAN, CAP) has no differences with the bleached group without antioxidants (BL). Adhesive failures were predominant in the groups that did not receive the antioxidant application. In conclusion, the evaluated antioxidants did not show an effect on the fracture strength, hybrid layer thickness, or bond strength of dentin bleached after endodontic treatment. The application of 10% sodium ascorbate, 10% alpha-tocopherol, 5% cranberry, or 0.0025% capsaicin solutions is not an effective step and should not be considered for the restorative protocols after non-vital bleaching.

Resumo Este estudo teve como objetivo avaliar o efeito de soluções antioxidantes na resistência à fratura e resistência de união em dentes tratados endodonticamente e clareados (38% de peróxido de hidrogênio). Cento e oitenta espécimes de dentina foram obtidos, 60 para cada teste: resistência à fratura, espessura da camada híbrida e resistência de união. Os grupos (n=10) foram compostos aleatoriamente de acordo com o protocolo pós-clareamento: REST - restauração, sem clareamento; BL - clareamento + restauração; SA - clareamento, solução de ascorbato de sódio a 10% e restauração; AT - clareamento, solução de α-tocoferol a 10% e restauração; CRAN - clareamento, solução de cranberry a 5% e restauração; CAP - clareamento, solução de capsaicina 0,0025% e restauração. Os dados foram analisados com os testes ANOVA, Kruskal-Wallis, Dunn e Qui-Quadrado (α=0,05). Os maiores valores de resistência à fratura foram observados em REST (1508,96 ±148,15 N), sem diferença significativa para os grupos clareados (p>0,05), independente do uso de antioxidantes. A espessura da camada híbrida no grupo que não foi submetido ao clareamento (REST) foi significativamente maior do que em qualquer outro grupo. A resistência de união nos grupos clareado e tratado com antioxidantes (SA, AT, CRAN, CAP) não apresentou diferenças com o grupo branqueado sem antioxidantes (BL). As falhas adesivas foram predominantes nos grupos que não receberam a aplicação do antioxidante. Em conclusão, os antioxidantes avaliados não mostraram efeito sobre a resistência à fratura, espessura da camada híbrida ou resistência de união à dentina clareada após tratamento endodôntico. A aplicação de soluções de ascorbato de sódio 10%, alfa-tocoferol 10%, cranberry 5% ou capsaicina 0,0025% não é uma etapa eficaz e não deve ser considerada para os protocolos restauradores após clareamento não vital.

Abstract This in vitro study evaluated the effect of an experimental varnish containing 20% nano-hydroxyapatite (nHAP) associated with 5% stannous chloride (SnCl2) against erosive-abrasive wear on bovine dentin. Samples of bovine cervical dentin were pre-eroded (0.3% citric acid, pH 2.6 for 10 minutes) and randomized into 4 groups (n=10): Control group - experimental varnish without active ingredient (CG); experimental varnish containing 20% nHAP (nHG); experimental varnish containing 5% SnCl2 (24.800 ppm Sn2+) (SnG); experimental varnish containing 20% nHAP associated with 5% SnCl2 (18.300 ppm Sn2+) (nHSnG). After applying the materials, the erosive-abrasive challenges were performed for five days. Erosive dentin loss and analysis of the pattern of dentinal obliteration were performed by 3D confocal laser microscopy. A one-way ANOVA/Bonferroni test was performed to analyze the data (α=0.05). The SnG and nHSnG experimental groups presented more effectiveness in preventing erosive wear when compared to the other groups (p<0.05). There was no statistically significant difference between the SnG and nHSnG groups (p = 0.731) in tooth structure dentin loss. Regarding the amount of open dentinal tubules, the highest amount of obstructed dentinal tubules was demonstrated in SnG and nHSnG (p < 0.05) when compared to the others. Between SnG and nHSnG there was no significant difference (p = 0.952) in the amount of closed dentinal tubules in the dentin. Experimental varnishes containing 5% SnCl2 associated or not with 20% nHAP showed to be a promising strategy in preventing erosive-abrasive wear of dentin. In addition, nHSnG was able to obliterate dentinal tubules.

Resumo Este estudo in vitro avaliou o efeito de um verniz experimental contendo 20% de nano-hidroxiapatita (nHAP) associado a 5% de cloreto estanoso (SnCl2) contra o desgaste erosivo-abrasivo da dentina bovina. As amostras de dentina cervical bovina foram pré-erodificadas (0,3% de ácido cítrico, pH 2,6 durante 10 minutos) e aleatorizadas em 4 grupos (n=10): Grupo controle - verniz experimental sem ingrediente ativo (GC); verniz experimental contendo 20% nHAP (GnH); verniz experimental contendo 5% SnCl2 (24.800 ppm Sn2+) (GSn); verniz experimental contendo 20% nHAP associado a 5% SnCl2 (18.300 ppm Sn2+) (GnHSn). Após a aplicação dos materiais, os desafios erosivo-abrasivos foram realizados durante cinco dias. Perda de dentina erosiva e análise do padrão de obliteração dentinária foram realizadas por microscopia laser confocal 3D. Foi realizado o teste ANOVA/Bonferroni unidireccional para analisar os dados (α=0,05). Os grupos experimentais GSn e GnHSn apresentaram maior eficácia na prevenção do desgaste erosivo quando comparados com os outros grupos (p<0,05). Não houve diferença estatisticamente significativa entre os grupos GSn e GnHSn (p = 0,731) na perda de dentina da estrutura dentária. Relativamente à quantidade de túbulos dentinários abertos, a maior quantidade de túbulos dentinários obstruídos foi demonstrada em GSn e GnHSn (p < 0,05) quando comparada com os outros grupos. Entre GSn e GnHSn, não houve diferença significativa (p = 0,952) na quantidade de túbulos dentinários fechados na dentina. Os vernizes experimentais contendo 5% de SnCl2 associados ou não a 20% de nHAP mostraram ser uma estratégia promissora na prevenção do desgaste erosivo-abrasivo da dentina. Além disso, o GnHSn conseguiu obliterar os túbulos dentinários.

Abstract This study evaluated the effect of aging and cementation of fiber posts using glass ionomer and resin cements on push-out bond strength, failure mode, and resin tag formation. One hundred and twenty bovine incisors were used. After post-space preparation, the specimens were randomly allocated into 12 groups (n = 10) according to the cementation system used: GC - GC Gold Label Luting & Lining); RL - RelyX Luting 2; MC - MaxCem Elite; RU - RelyX U200 and the aging periods (24 hours, 6 months, and 12 months). Slices from the cervical, middle, and apical thirds were obtained and analyzed by push-out bond strength test and confocal laser scanning microscopy. One-way ANOVA and Tukey’s post-hoc test was used at a significance level of 5%. For the push-out bond strength test, no differences among GC, RU, and MC in the cervical and middle thirds were observed, regardless of the period of storage (P > 0.05). In the apical third, GC and RU showed similar bond strength but higher than other groups (P > 0.05). After 12 months, GC showed the highest bond strength (P < 0.05). Bond strength to post-space dentin decreased over time, regardless of the cementation system used. Cohesive failure was the most frequent, regardless of the period of storage, cementation system, and post-space third. Tag formation was similar among all groups. After 12 months, GC showed the highest bond strength values.

Resumo Avaliar o efeito do envelhecimento e sistemas de cimentação usando ionômero de vidro e cimentos resinosos na resistência de união à dentina após a cimentação do pino de fibra. Cento e vinte incisivos bovinos foram utilizados. Após o preparo do pós-espaço, os corpos de prova foram distribuídos aleatoriamente em 12 grupos (n = 10) de acordo com o período de envelhecimento (24 horas, 6 meses e 12 meses) e o sistema de cimentação utilizado: GC - cimento de ionômero de vidro (GC Gold Label Cimentação e Revestimento); RL - RelyX Luting 2; MC - MaxCem Elite; RU - RelyX U200. Cortes dos terços cervical, médio e apical foram obtidos e analisados por teste de resistência de união push-out e microscopia confocal de varredura a laser. ANOVA one-way e teste de Tukey foi usado a um nível de significância de 5%. Para o teste de resistência de união, não foram observadas diferenças entre GC, RU e MC nos terços cervical e médio, independentemente do período de armazenamento (P > 0,05). No terço apical, GC e RU apresentaram resistência de união semelhante, porém superior aos demais grupos (P > 0,05). Após 12 meses, o GC apresentou a maior resistência de união (P < 0,05). A resistência de união à dentina no espaço para pino diminuiu ao longo do tempo, independentemente do sistema de cimentação utilizado. A formação de tags foi semelhante entre todos os grupos. Após 12 meses, o GC apresentou os maiores valores de resistência de união.

ABSTRACT: To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p<0.05). ΔE00 values indicated that all the groups did not show changes between the evaluation times (p>0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p < 0.023), although no differences were observed between BG45S5 and BIO groups (p = 1.000). No differences in enamel microhardness were found between the groups within the same evaluation time (p>0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

RESUMEN: Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p<0.05). Los valores de ΔE00 indicaron que todos los grupos no presentaron cambios entre los tiempos de evaluación (p>0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p < 0,023), no obstante, diferencias entre los grupos BG45S5 y BIO (p = 1,000) no fueron observadas. No se encontraron diferencias en la microdureza del esmalte entre los grupos dentro del mismo tiempo de evaluación (p>0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

ABSTRACT: Bioactive materials have shown positive results in reducing the deleterious effects of tooth whitening. However, their effects on whitening efficacy is still uncertain. Therefore, the aim of this study was to evaluate the effects of F- 18 bioactive glass incorporation into a bleaching gel on color and microhardness of enamel after tooth whitening. Thirty bovine enamel-stained specimens were randomly divided into three groups (n=10) according to the whitening protocol: control group (unbleached), HP35 % (35 % hydrogen peroxide) and F-18 (F-18 bioactive glass incorporated into HP35 %). pH, color change and microhardness analyzes were performed at baseline, 24 hours and 7 days after tooth whitening. Color evaluation showed that experimental groups were different than control group for all coordinates (p < 0.05). However, no intragroup differences were observed (p > 0.05). No differences in enamel microhardness were found among the groups within the same evaluation time (p > 0.118). Regarding the intragroup comparisons, no differences were observed for control and F-18 groups (p > 0.129). It was concluded that F-18 bioactive glass incorporation did not affect the whitening efficacy and the enamel microhardness.

RESUMEN: Los materiales bioactivos han mostrado resultados positivos en la reducción de efectos nocivos del aclaramiento dental. Sin embargo, sus efectos sobre la eficacia del aclaramiento aún son inciertos. Por lo tanto, el objetivo de este estudio fue evaluar los efectos de la incorporación de vidrio bioactivo F-18 en un gel aclarador sobre el color y la microdureza del esmalte después del aclariamiento dental. Treinta especímenes bovinos teñidos con esmalte se dividieron aleatoriamente en tres grupos (n=10) de acuerdo con el protocolo de aclaramiento: grupo control (sin aclaramiento), HP35 % (peróxido de hidrógeno al 35 %) y F-18 (vidrio bioactivo F-18 incorporado en HP35 %). Se realizaron análisis de pH, cambio de color y microdureza al inicio del estudio, 24 horas y 7 días después del aclaramiento dental. La evaluación del color mostró que los grupos experimentales eran diferentes al grupo de control en todas las coordenadas (p < 0,05). Sin embargo, no se observaron diferencias intragrupo (p > 0,05). No se encontraron diferencias en la microdureza del esmalte entre los grupos dentro del mismo periodo de evaluación (p > 0,118). En cuanto a las comparaciones intragrupos, no se observaron diferencias para los grupos control y F-18 (p > 0,129). Se concluyó que la incorporación de vidrio bioactivo F-18 no afectó la eficacia de aclaramiento ni la microdureza del esmalte.

ABSTRACT: This clinical case described the aesthetic treatment of a patient complaining about the aspect of their upper teeth. After anamnesis and clinical examination, the association of tooth whitening photoactivated by violet LED and resin composite restorations was indicated. Prior to restorative treatment, three bleaching sessions were performed with low concentration hydrogen peroxide (6 %; Nano white flex) for 30 minutes. During this period, violet LED irradiation was intercalating performed every 1 minute, totalizing 15 minutes. Ten days after the final bleaching session, old restorations in the upper lateral incisors were removed for better color selection of resin composites. Then, all upper anterior teeth were directly restored with nanofilled resin composite (Filtek Z350XT), reestablishing anatomy, form, and function. At the end of the treatment, the association of techniques proved to be cost-effective, restoring the esthetics satisfactorily and promoting the patient's well-being by a minimally invasive approach.

RESUMEN: En este reporte de caso se describió el tratamiento para una paciente que se quejaba del aspecto de sus dientes superiores. Tras anamnesis y exploración clínica, se indicó la asociación de blanqueamiento dental fotoactivado por LED violeta y restauraciones de resina compuesta. Antes del tratamiento restaurador, se realizaron tres sesiones de blanqueamiento con peróxido de hidrógeno de baja concentración (6 %; Nano white flex) durante 30 minutos. Durante este período, la irradiación con LED violeta se intercalaba cada 1 minuto, totalizando 15 minutos. Diez días después de la última sesión de blanqueamiento, se retiraron las restauraciones antiguas de los incisivos laterales superiores para una mejor selección del color de la resina compuesta. Luego, todos los dientes anteriores superiores fueron restaurados de manera directa con resina de nanorrelleno (Filtek Z350XT), restableciendo la anatomía, forma y función. Al final del tratamiento, la asociación de las técnicas resultó beneficioso, restaurando la estética de forma satisfactoria y promoviendo el bienestar de la paciente mediante un abordaje mínimamente invasivo.

ABSTRACT: The objective of this in vitro study was to assess the effects of two antioxidants (sodium ascorbate [SA] and alpha-tocopherol [AT]) on the adhesive interface and dentin bond strength immediately after bleaching with 38 % hydrogen peroxide (38HP) in endodontically-treated teeth. Two stages of experimentation were carried out. Bovine incisors were allocated into four groups (n = 10/group for each experiment): NB, non-bleached restored crowns; 38HP, bleached and immediately restored crowns; 38HP-SA, bleached crowns and SA use; and 38HP-AT, bleached crowns and AT use. Hybrid layer length in dentin (μm) and bond strength (MPa) were assessed with confocal microscopy laser and micro-shear bond strength (μSBS) test, respectively. Failure mode was determined by stereomicroscope. Data analysis was performed with analysis of variance (ANOVA) and Kruskal-Wallis, Dunn, Tukey, and Fisher-exact tests (a = 0.05). Higher values of hybrid layer length were observed similarly in the NB and 38HP-SA groups. The highest μSBS mean values were observed in the NB group (18 .51 ? 1.33), whereas the SBS values for 38HP-AT (1.68 ? 0.32) were similar to the 38HP group (1.61 ? 0.51) (p > 0.05) and significantly lower than the 38HP-SA group (5.78 ? 0.71). Adhesive failures were predominant in the 38HP and 38HP-AT groups. Cohesive and mixed failures were mostly observed in the NB and 38HP-SA groups, respectively. In conclusion, AT has no immediate effect on the hybrid layer formation and μSBS of dentin. Although SA promotes an increase in hybrid layer formation, it was not reflected in the μSBS values.

RESUMEN: El objetivo de este estudio in vitro fue evaluar los efectos de dos antioxidantes (ascorbato de sodio [AS] y alfa-tocoferol [AT]) sobre la interfaz adhesiva y la fuerza de unión de la dentina inmediatamente después del blanqueamiento con peróxido de hidrógeno al 38 % (38HP) en endodoncia. -Dientes tratados. Se llevaron a cabo dos etapas de experimentación. Los incisivos bovinos se dividieron en cuatro grupos (n = 10 / grupo para cada experimento): NB, coronas restauradas no blanqueadas; 38HP, coronas blanqueadas y restauradas inmediatamente; 38HP- AS, coronas blanqueadas y uso SA; y 38HP-AT, coronas blanqueadas y uso de AT. La longitud de la capa híbrida en dentina (μm) y la fuerza de unión (MPa) se evaluaron con láser de microscopía confocal y la prueba de fuerza de unión por micro-cizallamiento (μSBS), respectivamente. El modo de falla se determinó mediante estereomicroscopio. El análisis de los datos se realizó con análisis de varianza (ANOVA) y pruebas de Kruskal-Wallis, Dunn, Tukey y Fisher (α = 0,05). De manera similar, se observaron valores más altos de longitud de capa híbrida en los grupos NB y 38HP-AS. Los valores medios más altos de μSBS se observaron en el grupo NB (18,51 ? 1,33), mientras que los valores de SBS para 38HP-AT (1,68 ? 0,32) fueron similares a los del grupo 38HP (1,61 ? 0,51) (p> 0,05) y significativamente más bajos que el grupo 38HP-AS (5,78 ? 0,71). Las fallas adhesivas fueron predominantes en los grupos de 38HP y 38HP-AT. Las fallas cohesivas y mixtas se observaron principalmente en los grupos NB y 38HP-AS, respectivamente. En conclusión, la AT no tiene un efecto inmediato sobre la formación de la capa híbrida y el μSBS de dentina. Aunque AS promueve un aumento en la formación de capas híbridas, no se refleja en los valores de μSBS.

ABSTRACT: Orthognathic surgery is performed for the correction of craniofacial discrepancies. However, complications, such as tooth discoloration are possible. This case report presents two patients who underwent bilateral sagittal split ramus osteotomy associated with segmental Le Fort I osteotomy and genioplasty. During surgeries, the apical region of anterior teeth was accidentally injured in both cases. After three-week surgery follow-up, the injured teeth showed a change in color to dark pink. In both teeth, the root canal treatment was performed followed by the non vital tooth bleaching. Three sessions were necessary to achieve a significant color change of the teeth. The two-year follow-up showed that both teeth preserved an acceptable color. It was concluded that tooth discoloration after orthognathic surgery is a possible complication, which could be overcome following a conservative approach. Additionally, patients should be informed preoperatively.

RESUMEN: La cirugía ortognática es comúnmente realizada para corregir las discrepancias cráneo-faciales. Sin embargo, se pueden producir complicaciones tales como la pigmentación dentaria. Este reporte de casos presenta a dos pacientes que fueron sometidos osteotomía sagital bilateral de la rama mandibular asociada a osteotomía segmentaria Le Fort I y genioplastía. Durante la fase quirúrgica, la región apical de dientes anteriores fueron accidentalmente dañados en ambos casos. Después de tres semanas de seguimiento de la cirugía, los dientes afectados mostraron un cambio de color a rosado oscuro. Se realizó el tratamiento de conductos seguido de aclaramiento interno en ambas piezas dentarias. Fueron necesarias tres sesiones para lograr un cambio de color significativo. El seguimiento de dos años mostró que ambos dientess conservaron un color aceptable. En conclusión, la pigmentación dentaria después de la cirugía ortognática es una posible complicación, sin embargo, puede ser tratada por medio de un enfoque conservador. Además, los pacientes deben ser informados antes de la cirugía.

Abstract The aim of this study was to evaluate the effect of peracetic acid (PAA) as a single irrigant on the smear layer, on the intraradicular dentinal bond strength, and on the penetrability of an epoxy-based resin sealer into the dentinal tubules. A total of 120 roots were distributed into 4 groups according to the irrigant used in root canal preparation: 1% PAA (PAA); 2.5% NaOCl followed by final irrigation with 17% EDTA and 2.5% NaOCl (NaOCl-EDTA-NaOCl); 2.5% NaOCl (NaOCl); and saline solution (SS). The smear layer was evaluated using scanning electron microscopy. The bond strength of an epoxy-based resin sealer (AH Plus) to root dentin was evaluated by the push-out test and penetrability of the sealer into dentinal tubules was observed by confocal laser microscopy. The results were analyzed by the Kruskal-Wallis and the Dunn post-test (α = 0.05). The use of 1% PAA as single root canal irrigant provided smear layer removal and improved the penetrability and bond strength of AH Plus to root dentin in a manner similar to that of the NaOCl-EDTA-NaOCl group (p > 0.05). The NaOCl and SS groups had higher values of smear layer and lower values of sealer penetrability and dentin bond strength than the PAA and NaOCl-EDTA-NaOCl groups (p < 0.05). Thus, 1% PAA has the potential to be used as a single irrigant in root canals.

Resumo Introdução Os adesivos autocondicionantes apresentam técnica adesiva simplificada e diminuição na sensibilidade pós-operatória. Quando aplicados sobre a dentina, atuam sobre a smear layer, cuja efetiva remoção ainda constitui um desafio. Uma substância utilizada como pré-tratamento dentinário na ajuda da remoção da smear layer é o etilenodiamino tetracético dissódico (EDTA). Objetivo Avaliar os efeitos do EDTA em associação com sistemas adesivos autocondicionantes na resistência de união ao microcisalhamento. Material e método Foram seccionadas as superfícies oclusais de 72 terceiros molares humanos extraídos, para expor superfície dentinária plana. Os dentes preparados foram divididos em: dentina sem pré-tratamento; dentina tratada com EDTA 0,1M; dentina tratada com EDTA 0,5M. Cada grupo recebeu tratamento de três sistemas adesivos autocondicionantes: Single Bond Universal (SBU), AdheSE (AdheSE) e Clearfil SE Bond (CSEB). Foi delimitada a área adesiva e assim posicionada uma matriz transparente, para inserção com resina composta Z250XT seguida de polimerização por 40 segundos. Após 24 horas de armazenamento, os dentes foram submetidos ao ensaio de microcisalhamento. Os dados obtidos foram analisados estatisticamente, utilizando-se os testes Two-Way ANOVA e Bonferroni, e sendo considerado nível de significância de 5%. Resultado Não houve diferença estatística significante na resistência de união entre os pré-tratamentos dentinários (p=0,8353), porém houve diferença significativa entre os adesivos (p<0,05) CSEB e AdheSE, mostrando semelhança entre CSEB e SBU, e entre SBU e AdheSE. Conclusão O pré-tratamento dentinário com solução de EDTA não afetou a resistência de união com nenhum dos sistemas adesivos autocondicionantes utilizados.

Abstract Introduction Self-etching adhesives have simplified adhesive technique and decreased the postoperative sensitivity. When applied on dentin, it acts on the smear layer, but it is still a challenge in the effectiveness of this removal. A substance used as a pre-treatment for the removal of the smear layer is disodium ethylenediaminetetraacetic acid (EDTA). Objective To evaluate the effects of EDTA in association with self-etching adhesive systems on micro-shear bond strength. Material and method The occlusal surfaces of 72 extracted human third molars were sectioned to expose a flat dentin surface. The prepared teeth were divided into: dentin without pre-treatment; dentin treated with 0.1M EDTA; dentin treated with 0.5M EDTA. Each group received treatment of 3 self-etching adhesive systems: Single Bond Universal (SBU), AdheSE (AdheSE), and Clearfil SE Bond (CSEB). The adhesive area was delimited and positioned a transparent matrix for insertion with Z250XT composite resin followed by polymerization for 40 seconds. After 24h of storage, the teeth were submitted to the micro-shear test. The data were analyzed statistically using the Two-Way ANOVA and Bonferroni tests, considering a level of significance of 5%. Result There was no statistically significant difference in bond strength between dentin pre-treatments (p = 0.8353), but showed a significant difference between CSEB and AdheSE adhesives (p <0.05), showing similarity between CSEB and SBU, and between SBU and AdheSE. Conclusion Dentin pretreatment with EDTA solution did not affect bond strength with any of the self-etching adhesive systems used.

Resumo Introdução Se a restauração temporária, que sela o canal radicular contra o meio bucal, falhar ou solubilizar, a medicação intracanal pode ser parcialmente removida, diminuindo a eficiência do hidróxido de cálcio (CH). Objetivo Avaliar o potencial alcalinizante e a liberação de íons cálcio de resíduos de diferentes medicações intracanal, em diferentes períodos. Material e método Incisivos humanos foram endodonticamente instrumentados e divididos aleatoriamente (n=10). Os canais radiculares foram preenchidos com: G1⎯Hidróxido de cálcio (CH); G2⎯CH com 0.4% de digluconato de clorexidina (CHC); G3⎯CH com paramonoclorofenol camforado e glicerina (HPG); G4⎯CH mantido durante todo experimento, como controle positivo (PC) e G5⎯Sem medicação intracanal, como controle negativo (NC). Os espécimes foram imersos em água destilada durante 7 dias. A medicação intracanal foi removida dos grupos experimentais com um instrumento F1 (Protaper). Os dentes foram armazenados em água destilada por 24 horas, 7, 14 e 28 dias. Os dados foram submetidos aos testes ANOVA one-way e Tukey. Resultado Todos os grupos experimentais tiveram redução no potencial alcalinizante e na liberação dos íons cálcio, quando comparados ao controle positivo (p<0.05). Não houve diferença estatisticamente significante entre os grupos experimentais, independente do período (p>0.05). Conclusão O potencial alcalinizante e a liberação de íons cálcio dos resíduos de diferentes medicações intracanal, em diferentes períodos, foram similares entre si e menores que o controle positivo, onde a medicação foi mantida dentro do canal radicular, encorajando a sua troca quando a restauração falhar.

Abstract Introduction If the restoration, that seal the root canal from oral environment, failed or solubilize, the intracanal dressing could be partially removed, decreasing the efficiency of calcium hydroxide (CH). Objective To evaluate the alkalizing potential and calcium ions release of intracanal residues from different medications, in different periods. Materials and method Human incisors were endodontically instrumented and randomly divided (n=10). The root canals were filled with: G1⎯Calcium hydroxide (CH); G2⎯CH with 0.4% chlorhexidine digluconate (CHC); G3⎯CH with camphorated paramonochlorophenol and glycerin (HPG); G4⎯CH was maintained during all experiment, as positive control group (PC) and G5⎯ No medication was performed in the negative control group (NC). The specimens were immersed in distilled water for 7 days. The intracanal dressing was removed from the experimental groups using F1 instrument (Protaper). The teeth were stored in distilled water for 24 hours, 7, 14 and 28 days. pH value and calcium ions released were evaluated and the data were submitted to ANOVA one-way and Tukey tests. Result All experimental groups presented lower alkalizing potential and calcium ions release than PC (P<0.05). No significant difference was found among the experimental groups, regardless of the period (P>0.05). Conclusion The alkalizing potential and calcium ions release of residues from different intracanal dressing, in different periods, were similar and lower than the positive control group, that the medication was maintained inside the root canal, encouraging the replacement of intracanal dressing when the restoration fail.

Resumo Introdução Forradores cavitários à base de hidróxido de cálcio apresentam baixa resistência e alta solubilidade. Para resolver este problema, foi desenvolvido forradores à base de hidróxido de cálcio fotoativáveis contendo resina para melhorar suas propridades. Objetivo A proposta deste estudo foi avaliar a alteração de pH e liberação de cálcio de forradores fotoativáveis. Material e método Foram preparadas amostras (n=10) com Ultra-Blend® plus, Biocal ® (cimentos fotoativáveis) e Hydro C® (controle). As amostras foram armazenadas com 10 mL de água destilada e mantidas em estufa à 37 °C. Depois de 24 horas, 7 e 14 dias, foram avaliados os níveis de liberação de cálcio e a alteração de pH. Os dados foram analisados estatisticamente pelo teste ANOVA, seguido do pós teste Tukey (α = 0.05). Resultado Os resultados de pH mostraram Hydro C > Ultra-Blend plus > Biocal. Biocal apresentou a pior liberação de cálcio. Conclusão Materiais fotoativados apresentam menor liberação de cálcio e alteração nos valores de pH.

Abstract Introduction Cavity liners based calcium hydroxide present low strength and high solubility that is consider a disadvantage. In order to enhance these properties it was developed a light-cured cavity liner based calcium hydroxide containing resin. Objective The purpose of this study was to evaluate the pH and calcium release of light-cured cavity liners. Material and method There were prepared specimens (n=10) with the Ultra-Blend ® plus, Biocal® (light cured cements) and Hydro C® (control). The samples were stored in 10 mL of distilled water and maintained at 37 °C. After 24 hours, 7, and 14 days, there were analyzed pH and the release of calcium levels. The data were statistically analyzed by ANOVA and Tukey test (α = 0.05). Result The results of pH showed Hydro C > Ultra-Blend plus > Biocal. Biocal presented worst calcium release. Conclusion Light-cured materials present lower calcium release and alteration in pH values.

Abstract: Endodontic sealer residues remaining within the pulp chamber dentin after root canal obturation and cleaning with various solvents may compromise the appearance and the durability of dental restorations. Acid etching is routinely performed prior to application of dentine adhesive systems, but is effect on residual sealer material and the optimal time-point for performing etching, are unknown. Here, we evaluated the effect of acid etching on the dentin surface when performed either immediately or 7 days after removal of the endodontic sealer with two solvents, i.e., 95% ethanol or xylol. Forty crowns fragments from bovine incisors were impregnated with sealer and divided into 4 groups (n = 10 each), according to the dentin cleaning protocol and to the acid etching time-point: G1, 95.0% ethanol and immediate acid etching; G2, xylol and immediate acid etching; G3, 95.0% ethanol and acid etching after 7 days; and G4, xylol and acid etching after 7 days. Scanning electron microscopy (SEM) images (2000 ×) were obtained from each specimen and the number of open dentinal tubules counted and compared. Another 40 fragments were similarly prepared, and SEM images were obtained (500 ×) to score and compare the persistence of sealer residues on the dentin. G4 showed the most open dentinal tubules and the least epoxy resin-based sealer residues on the dentin surface (p < 0.05). The least epoxy resin-based sealer residues was obtained when acid etching, using 37% phosphoric acid, was performed after 7 days after cleaning the dentin with xylol.

Abstract This study evaluated the effects of 10% alphatocopherol on the fracture resistance of endodontically treated teeth subjected to tooth bleaching with hydrogen peroxide and immediately restored with composite resin. Fifty bovine incisors were selected, including 10 sound teeth that constituted the control group (G1 (C)). The remaining 40 teeth, which were endodontically treated, were divided into four groups (n = 10): G2 (CR), consisting of teeth immediately restored with composite resin; G3 (HP + CR), consisting of teeth subjected to tooth bleaching with 38% hydrogen peroxide and immediately restored with composite resin; G4 (HP + SA + CR), which received treatment similar to that used for G3, but with 10% sodium ascorbate gel applied after the bleaching protocol; and G5 (HP + AT + CR), which was similar to G4 but included 10% alphatocopherol gel as an antioxidant. After 24 h, composite restorations were performed, and teeth were subjected to a fracture resistance test at a speed of 0.5 mm/min in an electromechanical testing machine. The axial force was applied with an angle of incidence of 135° relative to the long axis of the root. Data were subjected to ANOVA and Tukey tests (p = 0.05). G1 exhibited the highest fracture resistance (p < 0.05). No significant differences among the other experimental groups were observed. The 10% sodium ascorbate and 10% alphatocopherol gels did not improve the fracture resistance of endodontically treated teeth subjected to bleaching with 38% hydrogen peroxide.