In terms of tooth sensitivity, the use of lower concentrations of in-office bleaching should be the first choice, suggesting greater biocompatibility and safety compared to a conventional HP35.
ResumoIntrodução: A detecção de pequenas lesões de cárie ainda é um desafio para profissionais da Odontologia, que em sua prática clínica dispõem de uma grande variedade de métodos para detectar cáries nas superfícies oclusais. Objetivo: Avaliar clinicamente a efetividade da câmera de fluorescência Vista Proof, da microcâmera intraoral digital Vista Cam e do critério visual ICDAS (International Caries Detection and Assessment System) para detecção de lesões de cárie nas superfícies oclusais. Material e método: Cento e sete dentes posteriores de pacientes adultos foram examinados visualmente e por meio de radiografias digitais por um examinador que os classificou de acordo com a presença ou ausência de cárie. Os dentes foram então avaliados por outro examinador que utilizou o ICDAS, fluorescência e imagens digitais ampliadas. A efetividade dos métodos foi mensurada por meio da sensibilidade, especificidade, razão de verossimilhança positiva e negativa. Para cada método, a curva ROC (Receiver Operating Characteristic) e a área sob a mesma -AUROC (Area Under the ROC curve) foram estimadas. Resultado: Houve excepcional capacidade discriminante para as imagens intraorais (AUROC=0,93) e para o ICDAS (AUROC=0,91), com diferença estatística não significativa entre eles (z=0,35, p=0,73). A fluorescência apresentou capacidade discriminante aceitável (AUROC=0,78), embora tenha sido menor que os outros. A razão de verossimilhança positiva para a fluorescência foi 2,32, comparado a 20,58 para a imagem intraoral e 58,11 para o ICDAS. Conclusão: Ambos os métodos e o ICDAS exibiram um adequado desempenho clínico, sendo que o ICDAS e a imagem intraoral foram mais efetivos que a fluorescência.Descritores: Cárie dentária; efetividade; diagnóstico; fluorescência. AbstractIntroduction: The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective: To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method: One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result: There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited a...
The aim of this study was to evaluate the antibacterial activity of a composite resin modified by 3D zinc oxide (ZnO) microstructures and to verify possible alterations on its mechanical properties. ZnO was synthesized by hydrothermal approach and characterized by X-ray diffraction (XRD), surface area by Brunauer, Emmett and Teller (BET), Fourier transform infrared spectroscopy (FTIR) and Field emission scanning electron microscopy (FESEM). The minimum inhibitory concentrations of ZnO against Streptococcus mutans, Escherichia coli, Staphylococcus aureus, and Candida albicans were determinated. The composite resin Filtek Z350XT (3M of Brazil) was blended with 0.2%, 0.5%, and 1% in weight of ZnO and submitted to antibacterial assay by direct contact test against S. mutans, the leading cause of dental caries and the most cariogenic oral streptococci. Additionally, it was performed compressive and diametral tensile strength tests of the modified composite resin. Microrods and hollow microrods of ZnO were obtained and its MIC values were found to be 125 μg/mL for S. mutans, 500 μg/mL for C. albicans and 62.5 μg/mL for S. aureus. For the tested concentrations, it was not found MIC against E. coli. The direct contact test showed a significant antibacterial capacity of modified composite resin (p > 0.05 for all concentrations). The compressive and diametral tensile strength remains no changed after inclusion of microparticles (p > 0.05 for all concentrations). The modification of the composite resin with small amounts of ZnO microparticles significantly inhibited the S. mutans growth on resin surface without significant alterations of its mechanical strength.
Hidden caries is a type of lesion visualized in dentin, mainly by means of bitewing radiographs, in which, clinically, the occlusal enamel appears healthy or minimally demineralized and radiographically presents progressive demineralization in dentin, which may progress and compromise the pulp-dentin complex. Although the etiology of hidden caries is unknown, many theories have been studied, including structural and anatomical defects of enamel, their specific microbiota and the use of fluoride, which is most accepted theory. Considering the clinical concern, since these lesions have a silent progression and often are not detected on routine clinical examinations, this study aims to conduct a critical discussion of the etiology, prevalence, diagnostic methods and treatment decision for lesions of hidden caries, alerting professionals about the importance of routine use of bitewing radiographs even in patients considered "cariesfree" or low risk of caries, for more effective diagnosis.
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