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OBJECTIVES: The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). METHODS: Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). RESULTS: Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). SIGNIFICANCE: The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.

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OBJECTIVE: A systematic review and a meta-analysis were performed to answer the following research question: Are there differences in the color match and surface texture of nanofilled/nanohybrid and hybrid composite in patients with direct posterior restorations? DATA: Randomized clinical trials that compared nanofilled/nanohybrid and hybrid composite in direct restoration in posterior teeth were included. For the analysis of the bias the risk of bias tool (RoB) was used. Meta-analyses of different pairs (nanofilled vs. hybrid and nanohybrid vs. hybrid composite) were conducted for surface texture and color match and other secondary outcomes at different follow-ups, using a random effects model. Heterogeneity was assessed with the Cochran Q test and I2 statistics. GRADE was used to assess the quality of the evidence. SOURCES: A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE, without restrictions. IADR abstracts (2001-2019), unpublished and ongoing trials registries, dissertations and theses were also searched. STUDY SELECTION: 28 studies remained. No study was considered to be at low RoB; four studies were judged to have high RoB, and the remaining were judged to have unclear RoB. RESULTS: For the primary and secondary outcomes variables no significant differences were detected between nanofilled/nanohybrid restorations and hybrid composite restorations in any of the study follow-ups (p > 0.08). The body of evidence for surface texture and color match was classified as moderate or low. CONCLUSION: No evidence of difference was found between nanofilled/nanohybrid and hybrid composite in any of the clinical parameters evaluated.

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Patients undergoing orthodontic treatment with fixed appliances are at risk of developing carious white spot lesions and gingival inflammtion because of the challenge of oral hygiene. The purpose of this study was to evaluate under home conditions the effectiveness of three different types of electric toothbrushes during active appliance therapy: Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Küsnacht, Switzerland), and Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). A manual technique, which included normal toothbrush, interdental brush, and dental floss, served as reference. The study was structured as a single-blind "Latin square design" study. Thirty-eigth orthodontic patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrusch. Oral hygiene was evaluated at the start of a new test period and after 2 and 4 weeks. Clinical scores included a modified O'Leary Plaque Index and Ainamo Gingival Bleeding Index. Wilcoxon rank testing for aggregated surfaces revealed statistically significantly lower plaque scores for Rota-dent than for the manual technique (p<0.01). For all other toothbrushes, no differences were found in comparison to the manual technique. For Plaque Indices of specific sites, statistical analysis revealed all electric toothbrushes to be equal to the manual technique. No differences in Gingival Bleeding Indices were found after 4 weeks with either toothbrush. Patients with poor oral hygiene who used Rota-dent and Braun Oral-B Plaque Remover OD5 had statistically significantly lower plaque scores compared with the manual technique (p<0.01; p<0.05); for patients with good oral hygiene, these differences were neutralized. It may be concluded that eletric toothbrushes of the new generation are a real alternative to the often laborious manual tooth cleaning procedures used during active appliance therapy. Patients with poor oral hygiene may benefit from them especially because plaque removal can be achieved easier and faster

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Os tratamentos ortodônticos com aparelhos fixos aumentam tanto o risco de cárie quanto o de gengivite através dos acessórios que retêm a placa bacteriana. Já no exame bucal, o ortodontista deve diagnosticar os riscos presentes e diminuí-los com medidas adequadas. Além disso, durante a fase ativa do tratamento, as desmineralizaçöes e inflamaçöes gengivais devem ser previnidas com a aplicaçäo de um verniz de clorexidina e de flúor, assim como por mais de um controle constante e eficaz, preventivo, contra a formaçäo de placa bacteriana

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Sessenta e uma bebidas diferentes foram analisadas em seu teor de flúor e pH usando-se um eletrodo específico para flúor e um pHmetro. As amostras foram coletadas dentre aquelas bebidas consumidas com freqüência pelos brasileiros, como refrigerantes tipo cola, guaraná, limäo e laranja, sucos, leite in natura e leite em pó, cervejas, águas minerais e chás (chá mate, chá preto). Com exceçäo do chá preto e uma água mineral com gás, todas as bebidas apresentaram concentraçöes de flúor abaixo de 1 ppm, a maioria delas abaixo de 0,4 ppm. Sucos, leite, chá mate e cinco de sete águas minerais mostraram teores de flúor abaixo de 0,1 ppm. O pH de todos os refrigerantes e sucos ficou entre 2,5 e 3,4. Todas as outras bebidas tiveram um pH acima de 4,0. As águas minerais tiveram um pH perto de 7,0

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A cárie dentária é considerada como uma doença multifatorial na qual a infecção com estreptococos mutans tem grande influência. A interação entre o microrganismo e o hospedeiro na fase inicial da cárie não causa um grande prejuizo, mas com o tempo causa danos irreversíveis ao hospedeiro. Um dos maiores desafios na prevenção da cárie hoje em dia é impedir a adesão de estreptococos mutans aos dentes na fase de erupção dentária. Quanto mais tarde a criança vier ser infeccionada com essas bactérias, menos cárie se desenvolverá. Além disso, como a erupção dos dentes é lenta e acontece em períodos, a colonização e distribuição das bactérias são determinadas por aquelas que já conseguiram estabelecer-se na boca durante a dentição primária. O controle da infecção é a chave de uma prevenção duradoura. Logo, se a microbiota estabelecida, não contiver estreptococos mutans será mínima a possibilidade de mudança de tal situação. Denominamos este quadro de prevenção-primária-primária. O presente artigo trata de vários métodos para alcançar esse objetivo: chupetas que liberam agentes preventivos durante a noite, o fortalecimento do sistema imune, a imunização passiva e ativa. Além disso é discutido o impacto para a saúde bucal no Brasil

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