Objective This survey aimed to assess the effects of coronavirus disease 2019 (COVID-19) on elective and urgency/emergency dental care and dentists concerned. Materials and Methods A web-based survey was performed using Google forms questionnaire sent to dentists in Brazil. Questions included: personal information, type of dental care provided during quarantine, if emergencies increased, the dental office biosafety routine, among others. The levels of concern about the impact of quarantine on dental care and patient oral health conditions and the economic impact on dental practices were evaluated using a 0- to 10-point scale. Statistical analysis included descriptive, percentages, one-way ANOVA, Tukey, and chi-square tests. Results During quarantine, 64.6% of the dentists attended only urgency/emergency treatments, while 26.1% maintained routine appointments, and 9.3% closed the dental offices. A higher percentage of dentists from the least affected states continued routine dental treatment; dentists were younger and presented a significantly lower level of concern about dental treatments and oral health conditions of their patients. An increase in urgency/emergency procedures was reported by 44.1% of the dentists, mostly due to the unavailability of routine/elective dental care and increased patient anxiety and stress. The main causes of urgency/emergency appointments were toothache, dental trauma, and broken restorations, besides the breakage of orthodontic appliances and temporomandibular disorders. Dentists reported a high level of concern about the economic impact caused by quarantine. Conclusions The pandemic/quarantine has negatively affected the clinical routine. Personal protection/hygiene care must be adopted and reinforced by dental professionals/staff to make dental procedures safer.

This survey aimed to assess the concerns of students of health-related higher education in Brazil regarding distance learning during the coronavirus pandemic. A Google Forms anonymous questionnaire was sent by WhatsApp Messenger to students at a private university. Seven hundred and four students answered the questionnaire (566 female, 138 male, mean age = 23.09 years), reflecting approximately a third of the students in health-related disciplines. Students reported feeling anxious due to the pandemic. Most of the students agreed with having the ability to continue education through distance learning, but relatively few of them enjoyed it. Also, students were concerned that learning of clinical material and professional training would be impaired, and they were afraid of failing the year of education. Health-related higher education private institutions in Brazil should focus on reassessing and prioritizing their policies and protocols and include a detailed plan for the future.

The results of this in situ study suggest that the mineral loss caused by in-office dental bleaching is minimal and is partly compensated by remineralization due to contact with saliva. Additionally, whiteness was not affected by daily exposition to coffee during the enamel remineralization, which indicates that avoiding the consumption of coffee immediately following in-office bleaching is unnecessary. (J Esthet Restor Dent 28:S23-S31, 2016).

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Polymer-based composite materials have been proposed as an alternative for single unit restorations, due to their resilient and shock absorbing behavior, in contrast to the brittleness of ceramic materials that could result in failure by fracture. Objective: To evaluate the fatigue strength and damage modes of monolithic posterior resin nanoceramic and lithium disilicate glass ceramic crowns. Methodology: Twenty-six resin nanoceramic (RNC) and lithium disilicate glass ceramic (LD) 2 mm monolithic crowns (n=13) were cemented on composite resin replicas of a prepared tooth and subjected to cyclic load with lithium disilicate indenters for 2 million cycles. Specimens and indenters were inspected every 500,000 cycles and suspended when presenting fractures or debonding. Surviving specimens were embedded in epoxy resin, polished and subsurface damage was analyzed. Specimens presenting fractures or severe subsurface damage were considered as failures. Survival data was subjected to Fisher's exact test; damage modes were subjected to Mann-Whitney test (p<0.05). Results: There were no debonding, cohesive or catastrophic failures. Considering subsurface damage, 53.8% of RNC and 46.2% of LD crowns survived the fatigue test, presenting no statistical difference. Chief damage modes were radial cracks for RNC and inner cone cracks for LD, presenting no statistical difference. Conclusions: The results suggest that if debonding issues can be resolved, resin nanoceramic figures can be an alternative to posterior crowns. Although distinct, damage modes revealed potential to cause bulk fracture in both glass ceramic and resin nanoceramic crowns.

Purpose To evaluate the fatigue survival, fracture loads and failure modes of monolithic lithium disilicate screw‐retained crowns, attached to titanium insert, and cement‐retained crowns. Materials and Methods Internal tapered connection implants, embedded in acrylic resin at 30° inclination, were restored with lithium disilicate restorations, simulating a maxillary premolar (n = 20), with different designs: screw‐retained titanium base abutment‐crowns, and cement‐retained crowns. The specimens were submitted to cyclic mechanical loading (1.2 × 106 cycles with a load of 0‐250 N at 2 Hz). Surviving specimens were subjected to single load to fracture in a universal testing machine and failure modes were determined with the aid of an optical microscope. Maximum load values were analyzed statistically using the t‐test and differences in failure modes were analyzed using the chi‐squared test (α = 0.05). Results All specimens survived the cyclic mechanical loading. Fracture load was significantly higher for screw‐retained crowns (821.69 ±196.71 N) than the cement‐retained crowns (577.03 ± 137.75 N) (p = 0.005). Ceramic failure was the predominant mode, with no statistical difference between groups. Conclusions Screw‐retained and cement‐retained lithium disilicate crowns survived the cyclic mechanical loading. The use of titanium inserts to support a monolithic restoration enhances the fracture strength of the crown/abutment system.

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Due to the risk of pulp exposure in deep carious lesions, stepwise excavation can be a conservative and successful option for selected cases, when signs and symptoms of a normal pulp are present. FF Lima • RC Pascotto • AR BenettiStepwise Excavation in a Permanent Molar:17-year Follow-up SUMMARYThe current study presents a 17-year clinical report of stepwise excavation and indirect pulp capping in a lower right first molar, with great dentin destruction and a lack of dentin support of the cusps. At the first appointment, indirect pulp capping with calcium hydroxide and a temporary filling with zinc oxide cement were performed to minimize the risk of pulp exposure during excavation. After 45 days, the remaining carious tissue was removed and a restoration with glass-ionomer lining (Vitrebond) and resin composite (P-50) was performed. Satisfactory morphology and function of the restoration and pulp vitality were preserved for 17 years, thus indicating that stepwise excavation can be a good treatment alternative in selected cases.