OBJECTIVES This study evaluated the influence of air-particle abrasion protocols on the surface roughness (SR) of zirconia and the shear bond strength (SBS) of dual-polymerized resin cement to this ceramic. MATERIALS AND METHODS Sintered zirconia blocks (n = 115) (Lava, 3M ESPE) were embedded in acrylic resin and polished. The specimens were divided according to the 'particle type' (Al: 110 µm Al2O3; Si: 110 µm SiO2) and 'pressure' factors (2.5 or 3.5 bar) (n = 3 per group): (a) Control (no air-abrasion); (b) Al2.5; (c) Si2.5; (d) Al3.5; (e) Si3.5. SR (Ra) was measured 3-times from each specimen after 20 s of air-abrasion (distance: 10 mm) using a digital optical profilometer. Surface topography was evaluated under SEM analyses. For the SBS test, 'particle type', 'pressure' and 'thermocycling' (TC) factors were considered (n = 10; n = 10 per group): Control (no air-abrasion); Al2.5; Si2.5; Al3.5; Si3.5; ControlTC; Al2.5TC; Si2.5TC; Al3.5TC; Si3.5TC. After silane application, resin cement (Panavia F2.0) was bonded and polymerized. Specimens were thermocycled (6.000 cycles, 5-55°C) and subjected to SBS (1 mm/min). Data were analyzed using ANOVA, Tukey's and Dunnett tests (5%). RESULTS 'Particle' (p = 0.0001) and 'pressure' (p = 0.0001) factors significantly affected the SR. All protocols significantly increased the SR (Al2.5: 0.45 ± 0.02; Si2.5: 0.39 ± 0.01; Al3.5: 0.80 ± 0.01; Si3.5: 0.64 ± 0.01 µm) compared to the control group (0.16 ± 0.01 µm). For SBS, only 'particle' factor significantly affected the results (p = 0.015). The SiO2 groups presented significantly higher SBS results than Al2O3 (Al2.5: 4.78 ± 1.86; Si2.5: 7.17 ± 2.62; Al3.5: 4.97 ± 3.74; Si3.5: 9.14 ± 4.09 MPa) and the control group (3.67 ± 3.0 MPa). All TC specimens presented spontaneous debondings. SEM analysis showed that Al2O3 created damage in zirconia in the form of grooves, different from those observed with SiO2 groups. CONCLUSIONS Air-abrasion with 110 µm Al2O3 resulted in higher roughness, but air-abrasion protocols with SiO2 promoted better adhesion. AbstractObjectives. This study evaluated the influence of air-particle abrasion protocols on the surface roughness (SR) of zirconia ceramic and the adhesion of dual-polymerized resin cement to this ceramic. Material and methods. Sintered zirconia blocks (N=115) (Lava, 3M ESPE) were embedded in acrylic resin and polished. The specimens were randomly divided into the following experimental groups considering the particle type (Al: 110 µm

Knowledge about security and the potential damage originated by the gingival displacement techniques has not been described through randomised clinical studies. This crossover, double-blind, randomised clinical trial evaluated clinical and immunological factors related to conventional and cordless gingival displacement (GD) techniques, and patients' perceptions in 12 subjects with the employment of 2 GD techniques: conventional (gingival cord + 25% AlCl3 astringent gel) and cordless (15% AlCl3 astringent-based paste). In each subject, two anterior teeth were treated and a 10-day wash-out period separated the two treatments. Periodontal indices were evaluated before (baseline) and 1 and 10 days after GD. Interleukin 1β, interleukin 6 and tumour necrosis factor α concentrations in gingival crevicular fluid were measured before and 1 day after GD. Subjective parameters (pain, unpleasant taste and stress) were also evaluated. Data were analysed by one-way repeated-measures analysis of variance and Tukey's test (immunological factors), the Friedman test (periodontal parameters) and Fisher's exact or chi-squared test (subjective parameters), with a significance level of 95%. Gingival bleeding index, probing depth and plaque index values did not differ significantly between groups at any timepoint. Neither technique resulted in worse periodontal indices. Both techniques yielded similar results for pain and unpleasant taste, but conventional GD was significantly more stressful than cordless GD for volunteers. Both treatments significantly increased mean concentrations of the three cytokines, with the conventional technique producing the highest cytokine levels. Cordless GD is less stressful for patients and results in lower post-treatment levels of inflammatory cytokines compared with conventional GD.

PurposeThis study was performed to evaluate and compare the radiopacity of dentin, enamel, and 8 restorative composites on conventional radiograph and digital images with different resolutions.Materials and MethodsSpecimens were fabricated from 8 materials and human molars were longitudinally sectioned 1.0 mm thick to include both enamel and dentin. The specimens and tooth sections were imaged by conventional radiograph using #4 sized intraoral film and digital images were taken in high speed and high resolution modes using a phosphor storage plate. Densitometric evaluation of the enamel, dentin, restorative materials, a lead sheet, and an aluminum step wedge was performed on the radiographic images. For the evaluation, the Al equivalent (mm) for each material was calculated. The data were analyzed using one-way ANOVA and Tukey's test (p<0.05), considering the material factor and then the radiographic method factor, individually.ResultsThe high speed mode allowed the highest radiopacity, while the high resolution mode generated the lowest values. Furthermore, the high resolution mode was the most efficient method for radiographic differentiation between restorative composites and dentin. The conventional radiograph was the most effective in enabling differentiation between enamel and composites. The high speed mode was the least effective in enabling radiographic differentiation between the dental tissues and restorative composites.ConclusionThe high speed mode of digital imaging was not effective for differentiation between enamel and composites. This made it less effective than the high resolution mode and conventional radiographs. All of the composites evaluated showed radiopacity values that fit the ISO 4049 recommendations.

This review investigates erosion and abrasion in dental structures undergoing at- home bleaching. Dental erosion is a multifactorial condition that may be idiopathic or caused by a known acid source. Some bleaching agents have a pH lower than the critical level, which can cause changes in the enamel mineral content. Investigations have shown that at-home tooth bleaching with low concentrations of hydrogen or carbamide peroxide have no significant damaging effects on enamel and dentin surface properties. Most studies where erosion was observed were in vitro. Even though the treatment may cause side effects like sensitivity and gingival irritation, these usually disappear at the end of treatment. Considering the literature reviewed, we conclude that tooth bleaching agents based on hydrogen or carbamide peroxide have no clinically significant influence on enamel/dentin mineral loss caused by erosion or abrasion. Furthermore, the treatment is tolerable and safe, and any adverse effects can be easily reversed and controlled.

The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

This aim of this study was to evaluate the physicochemical and biological properties of novel experimental cements (Hybrid, Paste and Resin) based on synergistic combinations of existing materials, including pH, diametral tensile strength (DTS) and cytotoxicity comparing them with mineral trioxide aggregate (MTA -Angelus ® ) and a glass ionomer cement (GIC) developed at our laboratory. For the physicochemical and biological tests, specimens with standard dimensions were produced. pH measurements were performed with digital pH meter at the following time intervals: 3, 24, 48 and 72 h. For the DTS test, cylindrical specimens were subjected to compressive load until fracture. The MTT assay was performed for cytotoxicity evaluation. Data were analyzed by ANOVA and Tukey's test (α=0.05). Paste group showed pH values similar to MTA, and Hybrid group presented pH values similar to GIC (p>0.05). The tested materials showed pH values ranging from alkaline to near neutrality at the evaluated times. MTA and GIC showed similar DTS values. The lowest and highest DTS values were seen in the Paste and Resin groups, respectively (p<0.05). Cell viability for MTA and experimental Hybrid, Paste and Resin groups was 49%, 93%, 90% and 86%, respectively, when compared with the control group. The photo-cured experimental resin cement showed similar or superior performance compared with the current commercial or other tested experimental materials.

Objective To evaluate the effect of storage time and temperature on the effectiveness of bleaching agents. Methods Enamel slabs were randomly allocated according to the concentration of carbamide peroxide (CP): 10% (CP10) and 16% (CP16). Shade evaluations were conducted at baseline and then after 3 and 12 months of storage at 3 different temperatures: 10°C (±2°C), 25°C (±2°C), and 35°C (±2°C). 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 (ΔS). Results The bleaching effect of different CP concentrations (10% and 16%) at baseline showed no differences with regard to objective (ΔE00) and subjective parameters (ΔS) (P > .05). No differences were observed between CP concentrations stored for the same length of time and at the same temperature for either parameter (P > .05). In terms of objective measurement (ΔE00), a reduction in the bleaching effect was shown for both CP concentrations (10% and 16%) when stored for 12 months at 35°C, and compared with the baseline (P < .05). As regards the subjective parameters (ΔS), after 12 months, both CP concentrations (10% and 16%) stored at 35°C showed a decrease in bleaching capacity compared to baseline (P < .05). CP10 and CP16 stored at 10°C and 25°C did not suffer any loss in bleaching ability, even after 12 months (P > .05). Conclusions The storage of bleaching agents for long periods at high temperatures can reduce the bleaching effectiveness of CP at 10% and 16%. Clinical Significance Clinicians must be made aware that they should store their bleaching products under proper temperature conditions and use them within an appropriate time frame; otherwise, the bleaching effect could be lost.

Objectives To estimate the incidence of the need for a dental prosthesis during early adulthood and its association with socioeconomic and oral disorder trajectories. Methods In 1982, in the city of Pelotas, all live births (n = 5914) and their mothers were assessed. A representative sample of this cohort study was examined for oral health conditions at 15, 24 and 31 years (Oral Health Study–OHS). The need for a dental prosthesis was assessed at 24 and 31 years of age, and variables of interest (gender, skin colour, socioeconomic status (SES), use of dental services, caries and periodontal disease) were collected from different waves of this cohort. Longitudinal association between outcome and variables of interest was assessed using multilevel mixed models. Results A total of 539 individuals were assessed in 2013 (60.7% response rate). The need for a dental prosthesis was 28.9% at 24 years. (95% CI 24.9‐33.2) and 49.0% at 31 years (95% CI 44.7‐53.3). Risk of presenting with a need for a dental prosthesis was higher in users of public services. Downwardly mobile and lower SES trajectory groups presented a higher risk of the need for a dental prosthesis. High‐risk caries trajectory group showed a higher risk of presenting with the need for a dental prosthesis from 24 to 31 years. Conclusions Our findings demonstrate that the need for dental prosthesis from 24 to 31 years old was determined by trajectories of exposure during the life cycle, reinforcing that tackling socioeconomic inequalities at any stage of life can have an effect on an individual's oral health.