Clinical Relevance
Secondary caries are the main reason for the failure of restorations, class II being the most affected. Techniques that promote less gap percentage are important. Flowable bulk fill composites used at such locations have been shown to decrease gap formation while being a faster procedure than an incremental technique.
Introduction: Within the treatment protocols of patients with cleft lip and palate, the nasoalveolar molding (NAM) acquire more followers every day.Their benefits have been well documented, but not equally their complications. The purpose of this study was to describe the complications produced during treatment with Grayson presurgical NAM in nonsyndromic infants with complete unilateral cleft lip and palate. Methods: Bibliographic review on 8 databases using search algorithms. By applying the exclusion and inclusion criteria, 21 articles were detected, which were analyzed in full text. Complication, cause, and solution data were presented in supplemental tables. Results: Complications are related to soft tissues, hard tissues, and those derived from care. Soft tissues: irritation, ulceration, gingival, facial, or nasal bleeding. Candidiasis. An overexpanded nostril creation to improper placement or modifications of the nasal stent at home.The most frequent were lip and cheeks skin irritation by taping, and gingival ulceration due to excessive pressure. Hard tissues: misalignment of alveolar segments and the premature eruption of teeth. Derived from care: inadequate device retention, adherence problems to treatment, poor/excessive care of the caregiver, intolerance to the device, eating problems, breathing, and socioeconomic issues. Conclusions: The main complications occur in soft tissues, related to the retention mechanisms and an inadequate adjustment of the device.The benefits of NAM exceed the complications. It is necessary to know them to avoid any harmful results since they could prolong or stop the treatment, compromising the result. The active collaboration of the family in the insertion and maintenance of the device is crucial for success.
Introduction: Orthodontic treatment for adults is currently increasing, and therefore the need to bond brackets to restorations and temporary crowns. The use of CAD/CAM PMMA provisional restorations for orthodontic purposes have not yet been described, and there is currently insufficient information regarding the strength of bracket adhesion. Objective: This study aimed at evaluating the effects of thermocycling (TC) and surface treatment on shear bond strength (SBS) of brackets to different provisional materials. Methods: Forty specimens were made from each material [PMMA (Telio Lab), bis-acryl (Telio CS C&B), and PMMA CAD/CAM (Telio CAD)], sandpapered, and divided according to surface treatment (pumiced or sandblasted) and TC (half of the samples = 1,000 cycles, 5°C/55°C water baths) (n = 10/group). Stainless-steel brackets were bonded to the specimens (using Transbond XT), and SBS testing was performed. Data were analyzed by three-way ANOVA and LSD post-hoc tests (α = 0.05). Failure types were classified with adhesive remnant index (ARI) scores. Results: SBS values ranged from 1.5 to 14.9 MPa. Sandblasted bis-acryl and sandblasted auto-curing PMMA groups presented similar values (p> 0.05), higher than the CAD/CAM material (p< 0.05), with or without TC. When thermocycled, pumiced bis-acryl showed higher SBS than pumiced acrylic (p= 0.005) and CAD/CAM materials (p= 0.000), with statistical difference (p= 0.009). TC showed negative effect (p< 0.05) for sandblasted bis-acryl and pumiced acrylic groups. ARI predominant score was mostly zero (0) for CAD/CAM, 1 and 2 for bis-acryl, and 1 for acrylic groups. Conclusion: In general, bis-acryl material showed the highest SBS values, followed by acrylic and CAD/CAM materials, which showed SBS values lower than an optimum strength for bonding brackets.
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