Aim The aim of this in vitro study was to compare machine and manual cementation of prosthetic elements by measuring internal and marginal fits. Methods Eighteen anatomic prefabricated abutments were used to manufacture zirconia copings in the Ceramill (n=9) and Lava systems (n=9). The copings were cemented with a fluid consistency addition silicone using a machine (n=18) and manually (n=18) according to the replica technique. They were then cut in the buccal-palatal and mesial-distal directions. The film thickness was photographed using an optical microscope and measured in the internal and marginal regions. The data collected were analyzed by repeated measures ANOVA and Bonferroni’s multiple comparison test (∂=.05). The Bland-Altman test was performed to evaluate the agreement between the methods. Results In the evaluation of the internal and marginal misfits, the mean values observed for the cementation performed with the aid of a machine and manually, were as follows: angular regions, 76.7 µm and 76.2 µm; linear regions, 60.6 µm and 60.7 µm; incisal region, 144.8 µm and 145.2 µm; marginal region, 40.1 µm and 40.2 µm; and overall mean, 80.4 µm and 80.6 µm, respectively. No significant differences were found between the 2 methods, for any of regions and systems (P>.05). The Bland-Altman test showed agreement between the methods (P>.05) and that the limits of agreement found were clinically acceptable. Conclusions Within the limitations of this in vitro study, we can conclude that cementation using manual techniques or mechanical aid produces the same cement films. fits n=9 n9 n 9 (n=9 n=9. . n=18 n18 18 (n=18 technique buccalpalatal buccal palatal mesialdistal mesial distal directions Bonferronis Bonferroni s ∂=.05. 05 ∂=.05 (∂=.05) BlandAltman Bland Altman misfits follows 767 76 7 76. 762 606 60 6 60. 607 region 1448 144 8 144. 1452 145 145. 401 40 1 40. 402 804 80 4 80. 806 respectively P>.05. P05 P P>.05 (P>.05 acceptable films n= (n= n=1 n1 (n=1 0 ∂=.0 (∂=.05 14 P0 P>.0 (P>.0 (n ∂=. (∂=.0 P>. (P>. ∂= (∂=. P> (P> ∂ (∂= (P (∂ (

Aim In recent years, great advances have been made in the use of CAD/CAM to prepare fixed restorations. The marginal and internal fit of these restorations is a principal determinant for their clinical success. In addition, the nature of the oral environment affects the mechanical properties of these restorations. Therefore, this study aimed to investigate the effect of aging process under conditions that simulate the oral environment on the marginal adaptation, and, fracture resistance of crowns fabricated from polyether ether ketone (PEEK) using CAD/CAM methods. Methods Twenty identical crown restorations were fabricated by using CAD/CAM methods to mill polyether ether ketone (PEEK) material. These crowns were produced by using a software design of an epoxy resin replica of the prepared maxillary first premolar tooth. All PEEK crowns were cemented and randomly divided into two equal groups (A, B). Each group was divided into subgroups (A1, A2 and B1, B2). Group A1 and A2 were used to measure marginal adaptation and fracture resistance, respectively, before aging, while group (B1 and B2) were measured after aging. The cemented crowns were mounted in resin molds to facilitate the sectioning process. The measurements of the marginal gap were performed after sectioning at four points using a stereomicroscope. The fracture resistance of the crowns was investigated using a universal testing machine. A statistical analysis was performed using the GraphPad Prism® software version and unpaired Student’s t-test. Results The results revealed that aging affected the marginal gap, and the fracture resistance of the PEEK crowns. While aging, negatively affected the conditions under investigation, however the least significant difference of marginal gap was found in the margin region. Conclusions PEEK-CAD/CAM is considered as a good alternative prosthodontic material for fixed prostheses. The CAD/CAM technique used to make PEEK crown restorations in our study offers the advantages of high marginal accuracy and fracture resistance for long-term performance in the oral environment. years CADCAM CAD CAM success addition Therefore (PEEK tooth A, (A B. B . B) A1, (A1 B1 B2. B2 respectively (B stereomicroscope machine Prism Students Student s ttest. ttest t test. test t-test investigation region PEEKCAD/CAM PEEKCADCAM prostheses longterm long term PEEKCAD

Aim Hyposalivation and dry mouth affect the quality of life in patients with Head and Neck Cancer, who did the treatment with radiotherapy. Thus this study has the objective to evaluate the dosimetric relationship between 3D radiotherapy and changes in salivary flow, xerostomia and quality of life in patients with head and neck cancer according to the volume of the irradiated parotid gland. Methods 23 patients with cancer in the head and neck area and in need of 3D radiotherapy were followed up during radiotherapy treatment, and the parotid gland (PG) design was also performed in radiotherapy planning. Questionnaires were carried out to determine xerostomia and quality of life, while the salivary flow was determined through calculations regarding the collection and weighing of saliva. Such data were collected in three moments: before the beginning of the radiotherapy treatment (D0), in the middle of the treatment (D1) and at the end of it (D2). The numerical variables are represented by measures of central tendency and measures of dispersion. Results when associating the salivary flow, the xerostomia questionnaire and the OHIP-14, a statistically significant difference was found (p-value <0.001), as well as when comparing some volumes of irradiated PG with the OHIP-14. However, no relationship was found between dosimetric data, xerostomia and hyposalivation. Conclusion patients undergoing 3D radiotherapy for malignant neoplasms in the head and neck region had decreased salivary flow, increased complaints of dry mouth and decreased quality of life. However, it was not possible to establish a statistically significant correlation between these findings and the volumes of irradiated parotids. Cancer D 2 (PG planning saliva moments D0, D0 , (D0) D1 (D1 D2. D2 . (D2) dispersion OHIP14, OHIP14 OHIP 14, 14 OHIP-14 pvalue p value <0.001, 0001 <0.001 0 001 <0.001) OHIP14. 14. However hyposalivation parotids (D0 (D (D2 OHIP1 1 OHIP-1 000 <0.00 00 OHIP- <0.0 <0. <0 <

Aim This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey’s post-hoc test. Statistical significance was set at p<0.05. Results A comparison of measurements between the 15-UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability. North 15UNC UNC 15 (15-UNC PCP12. PCP12 PCP . PCP-12) type program caliper examiners BlandAltman Bland Altman twoway way Tukeys Tukey s posthoc post hoc test p005 p 0 05 p<0.05 PCP-1 markings 1 mark variability PCP1 p00 p<0.0 PCP- p0 p<0. p<0 p<

Aim To evaluate the surface roughness and color stability of bulk-fill resin composites after simulated toothbrushing with whitening dentifrices. The radioactive/relative dentin abrasion (RDA) and radioactive/relative enamel abrasion (REA) of dentifrices were also assessed. Methods Specimens (n=10) of Tetric N Ceram Bulk Fill (TNCB), Filtek One Bulk Fill (FOB) resin composites, and Z100(Control) were prepared using a cylindrical Teflon matrix. Surface roughness (Ra, μm) was assessed by a roughness meter and the color evaluations (ΔEab, ΔE00, WID) were performed using a digital spectrophotometer based on the CIELAB system. Three measurements were performed per sample, before and after simulated toothbrushing with 3D Oral-B White Perfection (3DW) and Black is White (BW) dentifrices. The abrasivity (REA and RDA values) of the used dentifrices was also determined by the Hefferren abrasivity test. Results The Ra values increased significantly in all resin composites after 3DW and BW toothbrushing. The acceptable threshold color varied among resin composites, and TNCB and Z100 presented the highest ΔEab and ΔE00 for BW dentifrice. The 3DW dentifrice was significantly more abrasive than BW dentifrice on enamel and dentin. Conclusions simulated toothbrushing with tested whitening dentifrices increased the surface roughness at acceptable levels. The Tetric N Ceram Bulk-fill and Z100 composite showed the highest color alteration in BW. 3D White Perfection dentifrice was more abrasive on dentin and enamel than Black is White. bulkfill bulk fill radioactiverelative radioactive relative (RDA REA n=10 n10 n 10 (n=10 TNCB, , (TNCB) FOB (FOB Z100Control ZControl Control Z Z100(Control matrix Ra, (Ra μm ΔEab, (ΔEab ΔE WID system sample D OralB Oral B DW (3DW (BW test Z10 ΔE0 levels Bulkfill n=1 n1 1 (n=1 (TNCB Z1 n= (n= (n

Lip necrotizing lesions are painful, complex to heal, and negatively impact the patient’s orofacial condition. The present study reports a clinical case of a necrotizing lesion on the lower lip in a 38-year-old male patient, previously healthy, five days after receiving the first dose of the SARS-COV-2 vaccine, with an initial diagnosis of labial herpes zoster, with secondary infection and unsatisfactory response to clinical treatment. After debridement of the necrotic tissue, followed by a combination of antimicrobial photodynamic therapy (aPDT), photobiomodulation therapy (PBMT) and hydrofiber dressing with silver, the patient evolved with complete healing of the lip lesion and satisfactory restoration of orofacial functions after 7 days. According to the present case report, this combination of phototherapy modalities suggests to be a promising tool for the treatment of necrotizing labial lesions. painful heal patients s condition 38yearold yearold 38 year old healthy SARSCOV2 SARSCOV SARS COV 2 SARS-COV- vaccine zoster tissue aPDT, aPDT , (aPDT) PBMT (PBMT silver report 3 SARS-COV (aPDT

Aim Cyclooxygenase enzymes (COX) catalyze the conversion of arachidonic acid to prostaglandins and thromboxanes during pain and inflammation conditions. These enzymes have also been linked to several other conditions and diseases, and hence, in dentistry, it is crucial to identify the processes that increase the levels of these mediators. This paper aims to describe the significance of COX in dental practice through a narrative review. Methods Articles relating to COX upregulation published in English and Spanish over the last 51 years in databases such as EBSCO, Google Scholar, Science Direct, PubMed, and Web of Science; were analyzed. Results A total of 115 articles demonstrating the relationship between COX upregulation and multiple conditions and diseases of importance in prosthodontics, periodontics, oral pathology, orthodontics, and endodontics were included. Conclusions COX upregulation is related to inflammatory and malignant diseases in oral tissues, such as periodontitis, pulpitis, and oral cancer, nevertheless, its expression is advantageous in other fields of study such as orthodontics. Additionally, is well documented that dental materials provoke an undesired increase in COX expression, which could be a significant factor that directly affects pulpal health. (COX hence dentistry mediators review 5 EBSCO Scholar Direct PubMed analyzed 11 prosthodontics periodontics pathology orthodontics included tissues periodontitis pulpitis cancer nevertheless Additionally health 1

Aim This study aims to report the perioperative management of a patient with von Willebrand disease (vWd) who underwent orthognathic surgery. The report follows the guidelines of the Case Report Guidelines (CARE) and focuses on the steps taken to prevent bleeding during the surgical procedure. Methods A 39-year-old female patient with skeletal Class III was treated with maxillary advancement and mandibular setback. Despite normal test results for ristocetin cofactor activity, measures were taken to prevent bleeding, including atraumatic surgical techniques, use of antifibrinolytic medication, induced hypotension during anesthesia, and preparation of blood products for transfusion during trans and postoperative periods if needed. In the end, these measures were not required. Results The patient did not experience any bleeding during the surgical procedure or postoperative period, demonstrating the effectiveness of the measures taken to manage their blood dyscrasia. Two years after the surgery, the patient had satisfactory aesthetic and functional results and no evidence of relapse. Conclusion Thus, this case report demonstrates that vWd does not prevent large-scale oral and maxillofacial surgeries such as orthognathic surgery as long as proper precautions are taken pre-, intra- and postoperatively. (vWd CARE (CARE 39yearold yearold 39 year old setback activity techniques medication anesthesia needed end required period dyscrasia relapse Thus largescale large scale pre, pre , pre- intra postoperatively 3

Aim To evaluate the influence of notebook computers screens and undergraduate level of dental students in the radiographic detection of carious lesions. Methods Bitewing digital radiographs were presented to 3rd and 5th year dental students in three different notebooks computers: Notebook 1 with anti-glare screen (1366×768 pixels), Notebook 2 without anti-glare screen (1366×768 pixels), and Notebook 3 with anti-glare screen (1920×1080 pixels). A reference standard based on a consensus analysis was set by three senior professors of Oral Radiology and Cariology. Sensitivity, specificity and accuracy values were measured and submitted to two-way ANOVA at a significance level of 5%. Results Notebook 2 provided significantly lower sensitivity values (Mean 56.5% ± 2.94) than notebook 3 (71.1% ± 2.82) (p = 0.002). We found no statistically significant differences between the two undergraduate years (p > 0.05). Conclusion The anti-glare screen of notebook computers screens can influence the radiographic detection of carious lesions, but the undergraduate level of dental students does not influence this diagnostic task. lesions rd th antiglare anti glare 1366×768 1366768 1366 768 (1366×76 pixels, pixels , pixels) 1920×1080 19201080 1920 1080 (1920×108 pixels. . Cariology Sensitivity twoway way 5 5% Mean 565 56 56.5 2.94 294 94 71.1% 711 71 (71.1 2.82 282 82 p 0.002. 0002 0.002 0 002 0.002) 0.05. 005 0.05 05 0.05) task 1366×76 136676 136 76 (1366×7 1920×108 1920108 192 108 (1920×10 56. 2.9 29 9 71.1 7 (71. 2.8 28 8 000 0.00 00 0.0 1366×7 13667 13 (1366× 1920×10 192010 19 10 (1920×1 2. 71. (71 0. 1366× (1366 1920×1 19201 (1920× (7 (136 1920× (1920 ( (13 (192 (1 (19

Aim Venous blood derivatives (VBDs) have been suggested as substitutes for Fetal Bovine Serum (FBS) to improve the clinical transition of cell-based therapies. The literature is not clear about which is the best VBDs substitute. The present study aimed to evaluate the influence of VBDs on cell viability and describe a new method to seed these cells in a 3D Platelet-Rich Fibrin (PRF). Methods Blood was processed to obtain Platelet-Poor Plasma from PRF (P-PRF), Human Serum (HS), Platelet-Poor Plasma from PRP (P-PRP), activated-PRP (a-PRP), and Platelet lysate (PL). Cells were supplemented with each VBD at 10% and FBS at 10% was the control. Cell viability (fibroblast 3T3/NIH) test was evaluated with MTT assay in two ways: i) cell-seeded and expanded with VBD; ii) cell-seed with FBS and expanded with VBD. To seed the Fibrin construct, cells were suspended in PBS and dropped into the blood sample before performing Choukroun’s protocol for PRF. Constructs were cultured for 7 days in VBD supplements and FBS. Histological and Immunohistochemical analysis with vimentin was performed. Cell viability was analyzed by one-way ANOVA. Results VBD’s production time was very heterogeneous. Cells expanded in HS and a-PRP has grown faster. VBD-supplemented culture media provided cell culture highly sensible to trypsin/EDTA 0.25%. Cells seeded and expanded with VBD presented viability comparable to FBS in HS, a-PRP, and P-PRP (p>0.05) and lower in P-PRF and PL groups (p<0.05). The viability of cell seed with FBS and expanded with VBD was similar between P-PRF, a-PRP, PL, and FBS (p>0.05) and lower in HS and P-PRP (p<0.005). PRF-seeded cells showed a positive expression of vimentin and were able to maintain all cells supplemented with VBD. Conclusion VBD supplements were able to maintain fibroblast cells in 2D and 3D cultures. The new method of the fibrin-cell construct was efficient to insert the cells into the fibrin network. (VBDs (FBS cellbased based therapies substitute D PlateletRich Rich . (PRF) PlateletPoor Poor PPRF, PPRF P , (P-PRF) (HS) PPRP, PPRP (P-PRP) activatedPRP activated aPRP, aPRP (a-PRP) PL. (PL) 10 control 3T3/NIH 3T3NIH TNIH 3T3 NIH T ways i cellseeded ii cellseed Choukrouns Choukroun s performed oneway one way ANOVA heterogeneous faster VBDsupplemented trypsinEDTA trypsin EDTA 025 0 25 0.25% PRP, p>0.05 p005 p 05 (p>0.05 p<0.05. p<0.05 (p<0.05) PRF, p<0.005. p0005 p<0.005 005 (p<0.005) PRFseeded cultures fibrincell network (PRF (P-PRF (HS (P-PRP (a-PRP (PL 1 3T 02 2 0.25 p>0.0 p00 (p>0.0 p<0.0 (p<0.05 p000 p<0.00 00 (p<0.005 0.2 p>0. p0 (p>0. p<0. (p<0.0 (p<0.00 0. p>0 (p>0 p<0 (p<0. p> (p> p< (p<0 (p (p<

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified-Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration. freezedried freeze dried (DFDBA BMPs, BMPs , (BMPs) osteoinductive factors threewall wall However clear plateletrich rich iPRF i PRF (i-PRF patients method sitespecific site specific PI (PI) IBDD, (IBDD) modifiedSulcular modified Sulcular mSBI (mSBI) CAL (CAL) PPD (PPD 36 6 3- p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) p>0.05. p005 p>0.05 05 (p>0.05) (BMPs (PI (IBDD (mSBI (CAL p000 p<0.00 00 (p<0.001 p00 p>0.0 (p>0.05 p<0.0 (p<0.00 p0 p>0. (p>0.0 p<0. (p<0.0 p>0 (p>0. p<0 (p<0. p> (p>0 p< (p<0 (p> (p< (p

Aim This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures’ effectiveness to return clinical activities in the following months. Methods perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil. MarchAugust March August 2020 COVID19 COVID 19 COVID-1 SeptemberFebruary September February 2020/2021 20202021 2021 +64.2%, 642 +64.2% , 64 2 (+64.2%) 9235 9 235 9,23 so consequently 202 COVID1 1 COVID- 2020/202 2020202 +64.2 (+64.2% 923 23 9,2 20 2020/20 202020 +64. (+64.2 92 9, 2020/2 20202 +64 (+64. 2020/ +6 (+64 + (+6 (+ (

Aim This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p > 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873-0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085-8.602). Conclusions The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures. selfperceived self perceived clinics Selfperceived Self . (GOHAI) assessed retention balance dimension Chisquare, Chisquare Chi square, square Chi-square Pearson α 0.05. 005 0.05 0 05 0.05) 55191 55 1 9 55.1±9. evaluated p 0.006 0006 006 OR 0924 924 0.924 0.8730.978, 08730978 0.873 0.978 , 873 978 0.873-0.978) 76 7 6 7.6 0.034 0034 034 3.055 3055 3 055 1.0858.602. 10858602 1.085 8.602 085 8 602 1.085-8.602) (GOHAI 00 0.0 5519 5 55.1±9 0.00 000 092 92 0.92 8730 0.8730.978 0873097 0873 0.87 0978 0.97 87 97 0.873-0.978 7. 0.03 003 03 3.05 305 0858 1.0858.602 1085860 1085 1.08 8602 8.60 08 60 1.085-8.602 0. 551 55.1± 09 0.9 0.8730.97 087309 087 0.8 097 0.873-0.97 3.0 30 1.0858.60 108586 108 1.0 860 8.6 1.085-8.60 55.1 0.8730.9 08730 0.873-0.9 3. 1.0858.6 10858 10 1. 86 8. 1.085-8.6 55. 0.8730. 0.873-0. 1.0858. 1.085-8. 0.8730 0.873-0 1.0858 1.085-8 0.873- 1.085-

The maintenance of adequate fluoride (F) concentration in the public water supply is fundamental for ensuring that the community use of F can reach the maximum benefit for caries control and minimum risk for dental fluorosis. Thus, surveillance systems must use accurate and valid analytical methods to determine F concentration and, according to the literature, give preference to the ion-specific electrode (F- ISE) analysis. Aim The objective of this study was to compare the accuracy of the ISE and SPADNS methods in the determination of the F concentration in the same water sample. Methods Duplicate water samples were taken from 30 sampling sites in the municipality of Maringá, state of Paraná, monthly for 12 months, totaling 276 samples. An aliquot was analyzed by the FOP-UNICAMP Oral Biochemistry laboratory, using the F- ISE method, and the other one, by the SANEPAR laboratory in Maringá/PR, using the SPADNS method. Descriptive analysis and Pearson’s correlation test were applied, with a significant level of p<0.05. Results Results were expressed as ppm F (mg F/L), and a very strong positive correlation (r= 0.91; p<0.001) was detected between the two methods of analysis. Conclusion Our findings suggest that the determination of fluoride concentration in water can be made with accuracy by the SPADNS method, a standardized analysis protocol. (F fluorosis Thus literature ionspecific ion specific sample 3 Maringá Paraná 1 months 27 FOPUNICAMP FOP UNICAMP method one MaringáPR PR Maringá/PR Pearsons Pearson s applied p005 p 0 05 p<0.05 mg F/L, FL F/L , L F/L) r= r (r 0.91 091 91 p<0.001 p0001 001 protocol 2 p00 p<0.0 0.9 09 9 p<0.00 p000 00 p0 p<0. 0. p<0 p<

Aim To evaluate changes in the surface roughness and morphology of a nanofilled composite following toothbrushing with a whitening (WT) or regular toothpaste (RT), alone or combined with 35% hydrogen peroxide bleaching (HP). Methods Seventy disc-shaped nanofilled composite (Filtek Z350XT) specimens were randomly divided into groups (n=10): WT, RT, TB (without toothpaste – control) or the combinations WT/HP, RT/HP, TB/HP and HP. All groups underwent toothbrushing simulation (60,000 cycles) and bleaching treatment (4 sessions). Mean surface roughness (Ra, μm) was measured before (T0) and after treatments (TB). Surface morphology was assessed by scanning electron microscopy (SEM) at TB. Mean Ra was analyzed using general mixed models and multiple comparisons by the Tukey-Kramer test (α=5%). Results HP caused no surface roughness changes on the nanofilled composite after treatment (p>0.05). RT toothbrushing, combined or not with HP, increased the surface roughness (p<0.05). WT and WT/HP protocols had no effect on the surface roughness of the composite (p>0.05). The nanofilled composite submitted to RT toothbrushing combined with HP (RT/HP) presented substantial surface alterations under SEM, showing deep depressions and round-shaped defects. Toothbrushing with RT combined with the bleaching agent increased exposure of the inorganic fillers. Conclusion WT toothbrushing, regardless of HP combination, or the single HP protocol had no effect on the surface roughness of the nanofilled composite. However, RT combined with HP negatively affected surface roughness and presented the most noticeable surface changes among groups. (WT , (RT) 35 . (HP) discshaped disc shaped Filtek Z350XT ZXT Z XT n=10 n10 n 10 (n=10) without control WTHP RTHP RT/HP TBHP 60,000 60000 60 000 (60,00 cycles 4 ( sessions. sessions sessions) Ra, (Ra μm T0 T (T0 (TB) SEM (SEM TukeyKramer Tukey Kramer α=5%. α5 α α=5% 5 (α=5%) p>0.05. p005 p p>0.05 0 05 (p>0.05) p<0.05. p<0.05 (p<0.05) (RT/HP roundshaped round defects fillers combination However (RT 3 (HP n=1 n1 1 (n=10 60,00 6000 6 00 (60,0 (T (TB α=5 (α=5% p00 p>0.0 (p>0.05 p<0.0 (p<0.05 n= (n=1 60,0 600 (60, α= (α=5 p0 p>0. (p>0.0 p<0. (p<0.0 (n= 60, (60 (α= p>0 (p>0. p<0 (p<0. (n (6 (α p> (p>0 p< (p<0 (p> (p< (p