Abstract: The aim of this study was to compare the pulp vitality of primary teeth with deep caries treated with two restorative techniques. The restoration survival rate was also evaluated as a secondary outcome. Children aged from 4 to 8 years with at least one deep carious lesion in molars were selected at the Ibirapuera University dental clinic. One hundred and eight deciduous molars were allocated into two groups: (1) restoration with calcium hydroxide cement lining followed by filling with high-viscosity glass ionomer cement (CHC+HVGIC) or (2) restoration with HVGIC. Pulp vitality and restoration survival were evaluated at 6, 12, and 24 months. Intent-to-treat analysis was used for pulp vitality, and survival analysis was performed with the Kaplan-Meier method (α=5%). Results: At 24 months, 86 restorations were evaluated, and 91 were evaluated at least once during the study. There was no significant difference between the restorative treatments regarding pulp vitality (CHC +HVGIC=70% and HVGIC=68.5%) (OR=1.091; CI95%=0.481-2.475). However, HVGIC (73%) restorations showed a higher survival rate than CHC+HVGIC (50%) (p=0.021). Thus, it can conclude that deep caries in primary molars should be restored with HVGIC, since the technique results in similar pulp vitality to the CHC +HVGIC, but with a higher restoration survival rate.

Abstract: There is a lack of evidence about the best approach for cavitated caries lesions with the possibility of pulpal involvement in primary teeth. Thus, the present authors aimed to verify the best treatment for deep caries lesions with or without pulp involvement in primary teeth. The search was conducted in MEDLINE/Pubmed and Web of Science databases until May 2020. Studies that compared techniques to manage deep caries lesions with at least 12 months of follow-up were included. The risk of bias was evaluated using the RoB tool. Network meta-analysis and pairwise meta-analyses were conducted considering the treatment clinical success as an outcome, according to the pulp health condition. From 491 potentially eligible studies, 9 were included. For deep caries lesions with pulp vitality, the Hall Technique presented the highest probability of success (78%). In the event of accidental pulp exposure, pulpectomy presented a 76% chance of providing the best clinical results. For pulp necrosis, no difference was observed between a pulpectomy and non-instrumented endodontic treatment (RR = 0.69; 95%CI: 0.21–2.33) Thus, it was concluded that the Hall Technique may be a better option for deep caries lesions with pulp vitality. In cases of accidental pulp exposure of vital teeth during caries removal, a pulpectomy may be considered the best option. However, there are insufficient studies to build up evidence about the best treatment option when irreversible pulpitis or pulp necrosis is present.

O objetivo desta pesquisa foi avaliar a passividade através da medição da tensão induzida e adaptação passiva em infra-estruturas parafusadas sobre pilares, confeccionadas por tecnologia CAD/CAM, e comparar estas amostras com peças fabricadas por fundição convencional. Usando a tecnologia de CAD/CAM, quatro amostras foram feitas em zircônia (ZirCAD) e quatro amostras foram fabricados em cobalto-cromo (CoCrcad). Os grupos controle foram quatro espécimes de cobalto-cromo, feitos por fundição em monobloco (CoCrci), totalizando 12 infra-estruturas. Para avaliar a adaptação passiva, a diferença vertical entre a infraestrutura e o pilar protético foi medido em microscopia eletrônica de varredura (250 ×) quando apenas um parafuso foi apertado. A tensão média nestas infraestruturas foi analisada através do teste de fotoelasticidade. Foi observada uma diferença significativa na passividade entre os grupos controle e demais amostras. CoCrcad exibiu melhor valor de adaptação passiva (48,76±13,45 mm) e CoCrci o pior (187,55±103,63 mm), Zircad apresentou um valor intermediário (103,81±43,15 µm). Quando comparado com os outros grupos, CoCrci apresentou a maior tensão média ao redor dos implantes (17,19±7,22 kPa). Concluiu-se que a tecnologia CAD/CAM exibiu maior passividade em comparação com as infraestruturas confeccionadas pela técnica convencional. Infraestruturas confeccionadas em Co-Cr através do CAD/CAM apresentaram maior adaptação passiva em comparação com as amostras confeccionadas por CAD/CAM em zircônia. Entretanto, níveis de estresse similares foram obtidos para as estruturas fabricadas por CAD/CAM.

The objective of this research was to evaluate the passivity by measuring the passive fit and strain development of frameworks screwed on abutments, made by CAD/CAM technology, and to compare these parts with samples manufactured by conventional casting. Using CAD/CAM technology, four samples were made from zirconia (Zircad) and four samples were manufactured from cobalt-chrome (CoCrcad). The control groups were four specimens of cobalt-chrome, made by one-piece casting (CoCrci), with a total of 12 frameworks. To evaluate the passive fit, the vertical misfit at the abutment-framework interface was measured with scanning electron microscopy (250×) when only one screw was tightened. The mean strain in these frameworks was analyzed by photoelasticity test. A significant difference in the passive fit was observed between the control and sample groups. CoCrcad exhibited the best value of passive fit (48.76±13.45 µm) and CoCrci the worst (187.55±103.63 µm); Zircad presented an intermediate value (103.81±43.15 µm). When compared to the other groups, CoCrci showed the highest average stress around the implants (17.19±7.22 kPa). It was concluded that CAD/CAM-fabricated frameworks exhibited better passivity compared with conventionally fabricated frameworks. CAD/CAM-fabricated Co-Cr frameworks may exhibit better passive fit compared with CAD/CAM-fabricated zirconia frameworks. Even so, similar levels of stress were achieved for CAD/CAM-fabricated frameworks.