Aim: The publication in preprint format is an interesting open science practice that allows fast outreach to the society of new scientific findings. However, no previous study has investigated how much this practice has been adopted by dental scientists. Therefore, the objective of this study was to evaluate the adherence to the preprint publication format by a sample of Brazilian researchers. Methods: Searches were carried out, in September 2021, on the MedArxiv, OSF, and SciELO preprints platforms, looking for publications in preprint format by all Brazilian researchers of graduate programs in dentistry (n=211) who were productivity fellows in 2021 (PQ). Searches were performed by typing the authors’ full names and the possible variations, as indicated by each author's curriculum, openly available on the Lattes website platform. The data were analyzed through the Friedman test, with the Durbin-Conover post-hoc (α=0.05) in order to compare the three platforms. Spearman's correlation test (α=0.05) was performed to assess the possible correlations between the number of preprints and age, career stage, and the researcher’s scholarship level variables. Results: From the 211 researchers searched, 22 (10.4%) published 1 (one) preprint on at least one platform. A total of 39 published preprints were found at MedArxiv (n=19, 48.7%), SciELO preprints (n=18, 46.2%), and OSF platforms (n=2, 5.1%). There was no difference between the adherence to MedArxiv and SciELO preprints (p = 0.731). However, the OSF platform presented the lowest adherence, statistically differing from MedArxiv (p=0.008) and SciELO preprints platforms (p=0.003). In addition, no correlation was found between the publication of preprints and the researcher's age (p=0.128), career stage (p=0.248), or the researcher's scholarship level (p=0.661). Conclusion: It was possible to observe a low adherence to the preprints publications by Brazilian researchers’ productivity fellows of graduate programs in dentistry.

Abstract This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors’ highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson’s Chi-square tests, and Fisher’s Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

Abstract Objective Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel. Methodology 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments. Objective color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests. Results Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05). Conclusions At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.

Abstract Objective this study evaluated the mineral and microbiological response of biofilms originating from different types of saliva inoculum with distinct levels of caries activity. Methodology the biofilms grown over enamel specimens originated from saliva collected from a single donor or five donors with two distinct levels of caries activity (caries-active and caries-free) or from pooling saliva from ten donors (five caries-active and five caries-free). The percentage surface hardness change (%SHC) and microbiological counts served as outcome variables. Results the caries activity of donors did not affect the %SHC values. Inoculum from five donors compared to a single donor showed higher %SHC values (p=0.019). Higher lactobacilli counts were observed when saliva from caries-active donors was used as the inoculum (p=0.017). Pooled saliva from both caries activity levels showed higher mutans streptococci counts (p<0.017). Conclusion Overall, pooled saliva increased the mineral response of the derived biofilms, but all the inoculum conditions formed cariogenic biofilms and caries lesions independently of caries activity.

Abstract This study evaluated the effect of selective carious tissue removal on the fracture strength and failure mode of composite restorations in molars presenting only the buccal cusps. Deep cavities were prepared on the occlusal surface, and the lingual cusps were removed. Carious lesions in the middle of the pulpal wall were artificially induced with acetic acid (pH = 4.5) for 35 days. The demineralized dentin was left intact or was completely removed prior to restoration with a bulk-fill composite (n = 10). Images of the specimens were obtained by optical coherence tomography (OCT) before and after the caries induction/removal. The mechanical resistance to fracture by axial compressive loading and the failure type and extension were determined. The pulpal wall/composite interface of the fractured specimens was analyzed by OCT. The data were analyzed for significance with t-tests (α = 0.05). The deepest cavities and a more frequent occurrence of pulpal exposure were observed more often for non-selective carious tissue removal. The protocol of carious tissue removal did not affect the fracture strength (p = 0.554). An increased occurrence of catastrophic failures involving the roots was observed for non-selective carious tissue removal. Some occurrences of restoration displacement or cracks throughout the resin-dentin were observed only for the selective carious tissue approach. Selective carious tissue removal is a feasible approach to extensively damaged teeth since it reduced the occurrence of pulpal exposure and root fractures, without compromising the fracture strength.

Abstract Clinical interventions in dental practice should be determined based on the best scientific evidence available. Well-designed randomized clinical trials (RCTs) provide important evidence supporting the efficacy of interventions and are usually considered as the best primary evidence. However, the strict criteria adopted by most RCTs reduce their external validity since some findings from these studies might not work under usual conditions. On the other hand, practice-based research (PBR) studies have been designed to better define the effectiveness of clinical interventions under settings closer to “real-world” conditions. Therefore, this review aimed to describe different PBR designs discussing some advantages and limitations of such studies. The stimulus to organization PBR networks is discussed since the studies performed by these networks involve large number of clinicians and important conclusions can be drawn. Designs of observational studies including surveys and cohort studies based on practice are presented. Survey methods are important to know the behavior of practitioners regarding diagnostic and decision of treatment. Cohorts allow assessing different cofounders contributing to some outcome since large sample sizes and long follow-up periods can be observed in some of these studies. Pragmatic trials designed to take place in real-world clinical practice settings are also discussed as a useful design to assess the effectiveness of clinical interventions. In conclusion, this review sought to present PBR studies as alternative designs to answer clinical questions, but not replacing randomized clinical trials.

Abstract The aim of this study was to investigate the mechanical performance and the fracture behavior of endocrown restorations prepared using distinct restorative materials. A total of 42 sound molars with similar crown size and shape were cut at 2 mm above the cementoenamel junction and endodontically treated. They were categorized according to the restorative material used to fabricate endocrown restorations (n=7), namely, conventional composite (Filtek™ Z350 XT), bulk fill composite (Filtek™ Bulk Fill), conventional composite modeled using resin adhesives (SBMP: Scotchbond™ Multipurpose Adhesive; or SBU: Scotchbond™ Universal Adhesive), and IPS e.max lithium disilicate (Ivoclar Vivadent; positive control). Unprepared sound teeth were used as negative control. All endocrowns were bonded using a self-adhesive cement (Rely-X™ U200). The teeth were submitted to fatigue (Byocycle) and fracture (EMIC DL500) testing. Load-to-fracture (in N) and work-of-fracture (Wf, in J/m2) values were analyzed by ANOVA (p < 0.05). The endocrowns did not fracture or de-bond upon fatigue, showing similar load-to-fracture and work-of-fracture values, regardless of the restorative material (p > 0.05). The endocrowns fabricated by combining Z350 and SBMP had the least harsh fractures, in contrast to endocrowns prepared using Z350 only, which exhibited an equilibrium between repairable and irrepairable fractures. The e.max endocrowns exhibited more aggressive failures (root fracture) than other groups, resulting in higher rates of irrepairable fractures. In conclusion, dental practitioners may satisfactorily restore severely damaged nonvital teeth using the endocrown technique. Composite endocrowns prepared using resin adhesive as modeler liquid or using bulk fill material may result in less aggressive failures, thus providing a new material perspective for endocrown restorations.

Resumo Este estudo retrospectivo comparou a taxa de falha anual (TFA), razões para falha e fatores influenciadores da sobrevida de restaurações posteriores e anteriores de resina composta realizadas por estudantes de graduação. As restaurações deveriam estar em oclusão, com pelo menos um dente adjacente, e os pacientes deveriam ter comparecido a pelo menos 1 consulta anual de retorno. A investigação foi realizada em 2 analises separadas: 1) dados odontológicos de prontuário eletrônico de pacientes (n=333 restaurações) foram selecionados para avaliar os fatores influenciadores na sobrevida; 2) avaliação de 30 pacientes por exame clinico das restaurações (n=123) para verificar as características clinicas e a distribuição do tipo de falha. Os dados foram submetidos a Kaplan-Meier método, Log-rank teste, regressão de Cox e Teste Exato de Fisher (p<0,05). Após o período de 8 anos, a TFA foi 2,62%. Houve diferença entre restaurações anteriores e posteriores (p=0,005), sendo que anteriores mostraram maior TFA. Os fatores de risco à carie (p<0,001) e o número de superfícies restauradas (p=0,010) influenciaram a sobrevida de restaurações. Brilho superficial (p=0,029), fratura (p=0,025) e retenção (p=0,011) foram critérios clínicos com diferenças entre restaurações anteriores e posteriores. Renda (p<0,001), atividade de cárie (p<0,001), risco à cárie (p<0,001) e risco oclusal (p<0,001) também influenciaram a sobrevida. Após 8 anos, a TFA das restaurações realizadas por estudantes de graduação foram clinicamente aceitáveis e afetadas pelos fatores de risco associados ao pacientes e a posição do dente na arcada; restaurações anteriores falham mais do que posteriores.

Abstract This retrospective study aimed to compare the annual failure rate (AFR), reasons for failure and factors influencing survival of posterior and anterior composite restorations placed by undergraduate students. Composite restorations placed by undergraduate students were evaluated. The restorations should be in occlusion, with at least one adjacent tooth; and patients should have been present for check-up, with at least 1 annual recall. The investigation was performed in two separate analysis: 1) dental electronic records of 100 patients (n=333 restorations) were selected to assess factors influencing survival; 2) clinical evaluation of 30 patients by examining restorations (n=123) to assess clinical characteristics and failure type distribution. Data were subjected to Kaplan-Meier method, Log-rank test, Cox regression and Fisher’s Exact test (p<0.05). After 8-year period, the AFR was 2.62%. There was difference between anterior and posterior restorations (p=0.005), with anterior showing a higher AFR. The patient caries-risk (p<0.001) and the number of surfaces restored (p=0.010) affected restoration survival. The superficial brightness (p=0.029), fracture (p=0.025) and retention (p=0.011) were clinical criteria with differences between anterior and posterior restorations. Income (p<0.001), caries activity (p<0.001), caries risk (p<0.001) and oclusal risk (p<0.001) also influenced on the restorations survival. After 8-year, the AFR of restorations placed by undergraduate students was acceptable and affected by patient risk factors and the position of the tooth in the arch: anterior restorations failed more than posterior.

Resumo Introdução Modelos laboratoriais de biofilmes vêm sendo desenvolvidos com a finalidade de simular o ambiente bucal e o processo de formação da cárie dental. Objetivo Estabelecer e padronizar um modelo de biofilme in vitro para o desenvolvimento de lesões de cárie em dentina. Material e método Doze discos padronizados de dentina bovina foram divididos em três tempos experimentais: 4, 7 e 10 dias. As amostras de cada tempo experimental foram inoculadas com Streptococcus mutans UA 159 em meio de cultura BHI com 1% de sacarose e cultivadas em anaerobiose. As variáveis de resposta foram a perda de dureza integrada (ΔS) dos discos de dentina e dureza do substrato em diferentes profundidades. Os dados de ΔS foram analisados através de ANOVA seguido do teste Tukey, ambos com significância de 5%, e os dados de dureza de profundidade de lesão analisados descritivamente. Resultado Houve maior perda mineral aos 10 dias de crescimento microbiológico quando comparados aos 4 dias (p = 0,034), no entanto não houve diferença entre 7 e 10 dias (p = 0,853). O grupo de 4 dias mostrou perda de dureza em regiões mais superficiais (10-40µm); e o grupo de 10 dias mostrou desmineralização em áreas mais profundas, até 150 µm. Conclusão O modelo proposto mostrou-se capaz de desenvolver lesões de cárie artificiais em dentina. Em 7 dias, as lesões subsuperficiais de dentina foram adequadas para estudos de des-remineralização.

Abstract Introduction Oral laboratory biofilm models have been developed to reproduce the oral environment and the process of caries lesion formation in vitro. Objective To establish and standardize an in vitro biofilm model for the development of caries lesions in dentin. Material and method Twelve standardized bovine dentin discs were assigned into three experimental times: 4, 7, and 10 days. Samples of each experimental period were inoculated with Streptococcus mutans UA 159 in a BHI culture medium with 1% sucrose, and cultured under anaerobic conditions. The integrated hardness loss (ΔS) of dentin discs and the hardness of the substrate at different depths were considered as response variables. The ΔS data were analysed by ANOVA followed by Tukey's test, both with significance level of 5%, and the data of hardness at different depths were analysed descriptively. Result There was a higher hardness loss after 10 days of microbial growth when compared to 4 days (p = 0.034), however, there was no difference between 7 and 10 days (p = 0.853). The 4-day group showed loss of hardness of the surface layers (10-40μm) and the 10-day group showed demineralization in the deeper area around 150µm. Conclusion The proposed model was able to develop artificial caries lesions in dentin. In 7 days, the dentin sub superficial lesions were suitable to des-remineralisation studies.

Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Abstract Composites resins have become the first choice for direct anterior and posterior restorations. The great popularity is related to their esthetic appearance and reduced need of sound tissue removal as compared with former treatments. Several studies have demonstrated that composite restorations may last long in clinical service. In this review we discuss the factors playing a role on the long-term longevity. Composite restorations have demonstrated a good clinical performance with annual failure rates varying from 1% to 3% in posterior teeth and 1% to 5% in anterior teeth. Factors related to the patients such as caries risk and occlusal stress risk, in addition to socioeconomic factors, may affect the survival significantly. Characteristics of the clinical operators, particularly their decision making when it comes to observing or approaching an existing restoration, are decisive for longevity. Cavity features such as the number of restored walls, composite volume, and presence of endodontic treatment are of major importance and may dictate the service time of the restorative approach. The choice of restorative composite seems to have a minor effect on longevity provided that appropriate technical procedures are used. The main reasons for failure in posterior teeth are secondary caries and fracture (restoration or tooth/restoration), while in anterior teeth esthetic concerns are the main reasons leading to restoration failures. Composite resin restorations can be considered a reliable treatment as long as both the professional and the patient are aware of the factors involved in restoration failures.

Resumo O uso de guias de reporte tem um papel importante no desenvolvimento das pesquisas na saúde, melhorando a qualidade e a precisão das publicações. Esse estudo avaliou como periódicos de odontologia usam os guias de reporte. Todos editores de periódicos de odontologia registrados na lista do 2013 Journal of Citation Reports (n=81) foram convidados a participar. Dados foram coletados através de um questionário online autoaplicável. Informações sobre o perfil do periódico/editor e do uso de guias de reporte pelos periódicos foram coletados. Informações/recomendações sobre o uso de guias de reporte foram também coletados dos sites de todos os periódicos. Dados foram analisados descritivamente e frequências foram sumarizadas. Trinta e quatro (42%) editores completaram o questionário. Maioria dos periódicos é membro do Committee on Publication Ethics (64,7%) e/ou seguem as recomendações do International Committee of Medical Journal Editors (20,6%), enquanto 26,5% dos periódicos não são membros de nenhum grupo editorial. A maioria dos editores não é familiar com o EQUATOR Network (55,9%), não trabalha em tempo integral como editor (85,3%) e 88,2% recebem algum pagamento. A maioria deles recebeu treinamento para a posição de editor (55,9%). O CONSORT Statement foi endossado por 61,8% dos periódicos. Informações oriundas dos sites demonstraram que 44,4% dos periódicos não recomendam nenhum guia de reporte, 51,9% mencionam o CONSORT Statement no site e 28,4 apenas recomenda o CONSORT Statement. Existe um espaço claro para melhora no uso de guias de reporte em periódicos de odontologia. Um maior entendimento e endosso/aderência/implementação de guias de reporte por periódicos de odontologia pode promover a qualidade e transparência das pesquisas odontológicas publicadas.

Abstract The use of reporting guidelines has an important role in the development of health research, improving the quality and precision of the publications. This study evaluated how dental journals use reporting guidelines. All editors of dental journals registered on the 2013 Journal Citation Reports list (n=81) were invited to participate. The data were collected by a self-reported web-based questionnaire. Information about the profile of journal/editor and on the use of reporting guidelines by journals was gathered. Information/recommendations about the use of reporting guidelines were collected from the websites of all journals. Data were descriptively analyzed and frequencies were summarized. Thirty-four (42%) editors completed the questionnaire. Most journals are members of Committee on Publication Ethics (64.7%) and/or follow the International Committee of Medical Journal Editors recommendations (20.6%), while 26.5% are not members of any editorial group. Most editors are unfamiliar with the EQUATOR Network (55.9%), do not work full time (85.3%) and 88.2% have some income/payment. Most of them received educational training for this position (55.9%). The CONSORT Statement was endorsed by 61.8% of journals. Information from websites showed that 44.4% journals do not recommend any reporting guideline, 51.9% mention CONSORT Statement in the website and 28.4% only recommend the use of CONSORT Statement. There is clearly room for improving the use of reporting guidelines in dental journals. Broadening the understanding and the endorsement/adherence/implementation of reporting guidelines by journals may promote quality and transparence of published dental research.

Abstract The aim of this study is to evaluate the influence of modeling liquids on the translucency and color shade of resin composites (RCs) after one year of storage. RC specimens were prepared using either a conventional insertion technique (control; without modeling liquid) or a restorative dental modeling insertion technique (RDMIT) with dental adhesives as modeling liquids (Scotchbond™ Multi-Purpose [SBMP; 3M ESPE] or Adper™ Single Bond 2 [SB; 3M ESPE]). The initial colors of the specimens were obtained with a digital spectrophotometer and the CIEL*a*b* color system, after which specimens were stored (37°C) in distilled water or red wine for 12 months. Color measurements were reassessed after 6 and 12 months of storage, and scanning electron microscopy was performed after 12 months. Translucency and color change (ΔE*) were calculated and analyzed using ANOVA and Tukey’s test (α = 5%). RC samples prepared via RDMIT showed a translucency similar to that of control samples. ΔE* was also less intense for RCs containing SBMP than for RCs containing SB. Specimens stored in wine showed a clear pattern of degradation, especially in the control group, and surface degradation seemed to be less intense for specimens prepared with SBMP and SB than for specimens without. Specimens stored in water did not show clear evidence of surface degradation. RDMIT appears to be an interesting approach to reduce ΔE* in RCs over time without negative effects on the translucency of the material. However, the modeling liquid should feature a hydrophobic composition, similar to that used in the SBMP group, the achieve the best results.

Abstract Modeling liquids/resins have been used to build up resin composite (RC) restorations, although there is a lack of information regarding their effects on the color stability of the latter. Therefore, the purpose of the present study was to evaluate the effects of the presence of modeling liquid between layers of RC and the finishing/polishing state of the material on color change in specimens exposed to red wine staining over time. Specimens were prepared by placing four increments (±0.5 mm thick) of RC (Filtek™ Z350 XT, 3M ESPE) into molds; half of which were prepared by applying modeling liquid (Scotchbond™ Multi-Purpose™ Adhesive, SBMP, 3M ESPE) between the layers of RC, whereas the other half were prepared without SBMP (control). Light-activation was performed after application of the final RC layer using a light-emitting diode (Radii, SDI) curing unit with an irradiance of 900 mW/cm2 for 20 s. Each group was divided according to the surface finishing protocol (n = 7): nothing (non-polished) or polishing with Sof-Lex™/diamond paste (polished). Initial colors of the specimens were evaluated with a digital spectrophotometer and the CIEL*a*b* color system. The specimens were stored in wine (37°C) for 12 months, and the color measurements were reassessed after 4, 6, and 12 months of storage. Scanning electron microscopy (SEM) analysis was performed at the end. Data were analyzed using ANOVA and Tukey’s test (α = 5%). The presence of SBMP resulted in lower overall color change of the RC as compared with the control. The non-polished specimens exhibited a significantly higher color change than the polished specimens. SEM images corroborated the previous findings. In summary, the use of modeling liquid between layers of RC shows potential for application to reduce or delay the staining process of RC over time. Moreover, polishing is essential to provide increased color stability of the RC restoration.

Abstract Oral rehabilitation with osseointegrated implants is a way to restore esthetics and masticatory function in edentulous patients, but bacterial colonization around the implants may lead to mucositis or peri-implantitis and consequent implant loss. Peri-implantitis is the main complication of oral rehabilitation with dental implants and, therefore, it is necessary to take into account the potential effects of antiseptics such as chlorhexidine (CHX), chloramine T (CHT), triclosan (TRI), and essential oils (EO) on bacterial adhesion and on biofilm formation. To assess the action of these substances, we used the microcosm technique, in which the oral environment and periodontal conditions are simulated in vitro on titanium discs with different surface treatments (smooth surface - SS, acid-etched smooth surface - AESS, sand-blasted surface - SBS, and sand-blasted and acid-etched surface - SBAES). Roughness measurements yielded the following results: SS: 0.47 µm, AESS: 0.43 µm, SB: 0.79 µm, and SBAES: 0.72 µm. There was statistical difference only between SBS and AESS. There was no statistical difference among antiseptic treatments. However, EO and CHT showed lower bacterial counts compared with the saline solution treatment (control group). Thus, the current gold standard (CHX) did not outperform CHT and EO, which were efficient in reducing the biofilm biomass compared with saline solution.