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OBJECTIVES: This systematic review compared minimally and invasive surgical procedures to manage arthrogenous temporomandibular joint (TMJ). MATERIALS AND METHODS: The review included clinical trials assessing surgical procedures of arthrogenous temporomandibular disorder (TMD) management by carrying out comparisons within the same surgical procedure (pre- and post-treatment) as well as between different surgical procedures. Meta-analyses were conducted only for similar comparison reporting the same outcome measures, visual analog scale (VAS) values to evaluate pain and maximum incisal opening (MIO) values. RESULTS: Of the 1,015 studies identified by the search strategy, 26 were selected for full-text reading, and 19 were included in the review. Of these, 16 studies were included in the meta-analysis and 3 in the qualitative analysis. The VAS scores showed significantly lower values after discectomies (p < 0.001) and discoplasties (p < 0.001) in the within-group comparison. Moreover, significantly lower VAS scores and higher MIO values were observed after discectomy compared to arthroscopy, eminectomy, and discoplasty (p < 0.05). CONCLUSION: The findings of this systematic review suggest that although significantly lower VAS scores and higher MIO values were observed after discectomy, the currently available scientific evidence is unclear, and the use of invasive surgical procedures should not be implemented as an efficient first-line treatment option for arthrogenous TMD management. CLINICAL SIGNIFICANCE: VAS and MIO outcomes could be insufficient to describe the success or failure of open surgical procedures like discectomy and discoplasty.

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OBJECTIVES: This systematic review investigated the hypothesis that preheated resin composites (RCs) used as luting agents improve the mechanical properties, physicochemical performance, and color of indirect ceramic restorations. MATERIALS AND METHODS: Literature search was performed in three databases (Medline/PubMed, Scopus, and Web of Science) and in the grey literature (OpenGrey, ProQuest, and Catalog of Theses & Dissertations from CAPES). Eligibility criteria included only studies comparing at least one preheated RC used as a luting agent with resin cements. RESULTS: Data regarding the mechanical properties, physicochemical characteristics, and color were analyzed qualitatively, and the microtensile bond strength and film thickness were also evaluated by meta-analysis. The search strategy identified 3894 papers, and 28 were full-text screened. Seven studies were included in the review, and 5 were included in the meta-analysis. No significant difference was found for microtensile bond strength (P = 0.14). Preheated RCs showed significantly higher film thickness than resin cements (P = 0.001). CONCLUSION: Overall, the use of preheated RCs as luting agents offers similar to poorer performance than using resin cements for bonding indirect restorations. CLINICAL RELEVANCE: Despite the claim that preheated RC could be used as a luting agent, further studies should investigate the effect of clinically unacceptable film thickness.

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This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light- and dual-cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE00 ), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE00 , translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE00 , and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE00 and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set.

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OBJECTIVE: This cross-sectional clinical study evaluated the associations between sociodemographic, occupational, clinical conditions, psychological and sleep quality variables on definite sleep bruxism (SB). METHODS: All records obtained from adults (aged 20-60 years) and the elderly (aged >60 years) who had undergone polysomnography (PSG) at a private medical outpatients' clinic from July 2017 to February 2018 were reviewed. Data from a questionnaire, based on the criteria of the American Academy of Sleep Medicine (AASM), were also gathered. Definite SB data pattern distribution was analyzed, and multivariate Poisson regression with robust variance was used to assess the associations between definite SB diagnosis, determined via PSG recordings, and the independent variables. A significance level of 5% was adopted. RESULTS: A total of 240 individuals were included in the study and the SB prevalence was 7.08% (n = 17). The adjusted Poisson regression analysis revealed association between definitive SB and individuals with respiratory allergy (PR = 3.63; 95% CI:1.01-13; P = 0.047) and restless sleep (PR = 2.97; 95% CI:1.04-8.50; P = 0.042). CONCLUSION: This study found associations between definite SB and clinical conditions (respiratory allergy) and sleep behavior (restless sleep). Knowledge regarding factors associated with definite SB can contribute to decision making in the clinical setting and management strategies involving a multidisciplinary approach.

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OBJECTIVE: This study evaluated the association between the diagnosis of sleep bruxism (SB), scored by way of polysomnographic (PSG) recordings, clinical conditions and sleep architecture. DESIGN: A case-control study was conducted. All records from adults who had undergone polysomnography (PSG) recordings at a private medical outpatient clinic between January 2015 and December 2017 were reviewed. The sample included 58 bruxers (case group) and 58 non-bruxers (control group), identified based on the PSG recording and matched by sex and age. RESULTS: Obese individuals had significantly lower chance (OR 0.18; 95 % CI: 0.05-0.62; P = 0.005) of an SB diagnosis than individuals with normal BMI. Alcohol consumption significantly increased (OR 2.74; 95 % CI: 1.11-6.78; P = 0.029) and OSA decreased the chances (OR 0.55; 95 % CI: 0.23-1.30; P = 0.173) of an SB diagnosis. Bruxers had a significantly shorter wake time after sleep onset (WASO) (p = 0.002). As far as non-rapid eye movement (NREM) is concerned, the duration of stage N1 was statistically shorter (p = 0.034) and the duration of stage N3 was statistically longer (p = 0.001) in bruxers. Arousals (p = 0.013), arousals per hour (p = 0.009), respiratory disturbance index (RDI) values (p < 0.0005) and the apnoea-hypopnea index (AHI) (p = 0.002) were all lower in bruxers than in non-bruxers. CONCLUSION: The results of this study support a significant association between SB diagnosis, BMI and alcohol consumption. SB modified the sleep architecture as statistically significant differences were found between bruxers and non-bruxers for WASO, NREM stage N1 and N3, arousals, arousals per hour, RDI and AHI.

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INTRODUCTION: This cross-sectional study evaluated the influence of endodontic filling material, cervical limit of root filling, and tooth location on the color variation (∆E00 ) from 1 to 60 months of follow-up. MATERIALS AND METHODS: Color records were obtained from 70 participants who received 83 endodontic treatments. CIEL*a*b* color coordinates were measured on the homologous tooth, which was considered as baseline, and on endodontic treated teeth with a spectrophotometer. ∆E00 was calculated by the CIEDE2000 method at three conditions (condition 1: homologous tooth vs endodontically treated tooth after ≤1 month; condition 2: homologous tooth vs endodontically treated tooth after >1-12 months; condition 3: homologous tooth vs endodontically treated tooth after >12 months up to 5 years) for each variable. The zinc oxide and eugenol mineral trioxide aggregate or resin-based filling materials, dental cervix or ≥2 mm in the apical direction cervical limit of root filling and anterior or posterior tooth location were considered in the comparisons. Confidence intervals for the means (95% CI) were calculated, ∆E00 values and CIEL*a*b* individual color coordinates were compared for each pair of variables using the Student t test or Welch test (α = .05). RESULTS: Greater ∆E00 values were generally observed in the condition 3 for cervical limit (∆E00 = 10.7), use of zinc oxide and eugenol and mineral trioxide aggregate-based filling materials (∆E00 = 10.7), and anterior teeth (∆E00 = 12.4). Only in the condition 1, the ∆E00 values of the filling materials did not show statistical differences (P = .198). CONCLUSIONS: Higher ∆E00 values were yielded from zinc oxide and eugenol and mineral trioxide aggregate-based filling materials, anterior teeth, and dental cervix cervical limit of root filling. CLINICAL SIGNIFICANCE: Tooth discoloration yielded by endodontic materials and procedures is a challenge to clinical practice resulting in aesthetic problems and discomfort to both patient and professional, especially when it occurs in anterior teeth.

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STATEMENT OF PROBLEM: The inorganic filler of resin-based luting agents and the use of an adhesive layer could influence the bonding ability, mechanical performance, and interface morphology of bonded feldspathic ceramic. PURPOSE: The purpose of this in vitro study was to investigate the influence of resin-based luting agents loaded with different inorganic filler content, with or without an adhesive, on microtensile bond strength, biaxial flexural strength, and the adhesive interface morphology of bonded ceramic specimens. MATERIAL AND METHODS: Experimental resin-based luting agents with low (55wt%), intermediate (65wt%), and high (75wt%) filler contents were bonded to ceramic specimens, with or without a layer of adhesive. The resin-based luting agents were characterized by measuring viscosity, elastic modulus, Poisson ratio, and degree of conversion (n=3 for each test). The response variables for the bonded ceramic specimens were ceramic-resin microtensile bond strength (n=30), biaxial flexural strength (n=30) and characteristic strength, and Weibull modulus. Scanning electron microscopy was used for fractographic and interface analyses of the specimens fractured in the microtensile test (n=3). Data were subjected to ANOVA with the post hoc Tukey test (α=.05). Weibull moduli were also calculated. RESULTS: Increased inorganic filler content yielded significantly higher viscosity, stiffness, and film thickness. However, the Poisson ratio and degree of conversion were not affected. The lowest bond strength values were observed for the resin-based luting agents with high inorganic filler content when no adhesive was used and for the resin-based luting agent with low filler content when the adhesive was used. The increase in filler content of the resin-based luting agent appeared to be associated with a higher frequency of mixed failures. Increased filler content resulted in higher biaxial flexural and characteristic strength and decreased structural reliability. The adhesive helped fill irregularities on ceramic and slightly increased film thickness but had only a minor effect on mechanical strength. CONCLUSIONS: Experimental resin-based luting agent loaded with high inorganic filler content strengthened the bonded feldspathic ceramic and yielded significantly higher viscosity and film thickness. In contrast, the bond strength was lower if no adhesive was used.

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The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

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This study evaluated the effect of the accelerated artificial aging (AAA) on feldspar ceramic strength and the reinforcing effect promoted by adhesive cementation with resin luting agent. One hundred twenty feldspar ceramic disks were obtained. Sixty disks were acid-etched, silanized, and coated with an experimental resin luting agent simulating the adhesive luting procedures. Four groups were created (n=30): uncoated ceramic (control group), uncoated ceramic submitted to AAA, ceramic coated with resin luting agent, and coated ceramic submitted to AAA. Biaxial flexural testing with ball-on-ring setup was carried out. Biaxial flexural strength (s bf , MPa), characteristic strength (s 0 , MPa), and Weibull modulus (m) were calculated for axial positions z=0 (ceramic surface) and z=-t2 (luting agent surface). Data of s bf at positions z=0 and z=-t2 were separately submitted to statistical analyses (a=0.05). The uncoated ceramic submitted to AAA had no significant difference in s bf and s 0 compared with the control group. Resin coating of the ceramic increased s bf and s 0 at z=0. The AAA increased the s bf and s 0 for the resin-coated ceramic specimens at z=0 and also the s 0 at axial position z=-t2. The structural reliability at z=0 and z=-t2 was not influenced by the variables tested. In conclusion, resin coating improved the mechanical strength of the feldspar ceramic. The AAA procedure was not effective in aging the uncoated or resin-coated feldspar ceramic specimens.

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Introdução: a doença periodontal representa um fator de risco para o câncer bucal, uma vez que resulta no aumento na produção de espécies oxigênio-reativas, devido ao processo inflamatório em nível local e sistêmico. Essas substâncias interferem na estabilidade celular, podendo resultar no aumento da frequência de micronúcleos, que podem atuar como marcadores biológicos. Objetivo: buscar evidências científicas que demonstrem a relação entre a doença periodontal e a frequência elevada de micronúcleos. Métodos: a pesquisa foi realizada por meio de uma revisão sistemática da literatura em bases de dados científicas, utilizando os seguintes descritores: a) na Bireme: doença periodontal e micronúcleos; doença periodontal e análise citogenética; b) na PubMed: periodontal disease and micronuclei; periodontal disease and cytogenetic analysis. Resultados: a busca nas bases de dados totalizou 96 artigos. Desses, foram encontrados 3 na Bireme e 93 na PubMed. Dos 96 artigos encontrados, somente 4 responderam a questão norteadora. Desses, somente dois estudaram a relação entre a doença periodontal e outros fatores com a produção de micronúcleos. Os outros dois estudaram essa relação de forma isolada. Apenas em um artigo não foi observada significância estatística para a relação entre a frequência elevada de micronúcleos em sujeitos com a doença periodontal, quando comparados com sujeitos sem a doença. Em três dos quatro trabalhos, foi observada significância estatística entre esses fatores. Conclusão: sendo assim, destaca-se a importância em desenvolver estudos posteriores visando fortalecer essas evidências científicas, para que, futuramente, a análise de micronúcleos possa ser utilizada como um critério de controle prévio da carcinogênese.

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A constante busca pelo sorriso étnico cultural harmônico está fazendo com que, cada vez mais, as pessoas procurem o tratamento odontológico. Assim, o presente estudo teve como objetivo avaliar a percepção de estética dental de odontólogos que estavam cursando diferentes especialidades, levando em consideração o quanto isso afeta na sua conduta clínica. A coleta de dados foi realizada por meio de um questionário, composta por 108 cirurgiões dentistas cursando diferentes áreas de especialização em uma escola de pós-graduação no ano de 2016, em que cada participante avaliou fotografias que possuíam cinco alterações frequentes na dentição anterior. Foi realizada a análise descritiva dos dados e o teste qui-quadrado para a análise quantitativa. Através dos resultados, verificou-se que fatores como idade, especialização prévia e tipo de especialização em andamento apresentaram relação estatisticamente significante na percepção estética entre as diferentes áreas de atuação da Odontologia. Desse modo, foi possível concluir que o sorriso considerado esteticamente mais agradável entre os entrevistados possuía as seguintes características: plano incisal intermediário entre o reto e o que segue a linha do sorriso, nível gengival harmônico, ausência de desvio de linha média, ausência de diastema e matiz A1 (AU).

The constant search for a harmonious cultural ethnic smile is causing more people to seek dental treatment. Thus, the present study aimed to evaluate the perception of dental aesthetics by dentists who were studying different specialties, taking into consideration how much this affects their clinical behavior. Data collection was performed through a questionnaire of 108 dentists attending different areas of specialization at a postgraduate school in 2016, in which each participant evaluated photographs that had five frequent changes in the previous dentition. Descriptive data analysis and chi-square test were performed for quantitative analysis. The results showed that factors such as age, previous specialization and type of specialization in progress had a statistically significant relationship in the aesthetic perception in different areas of Dentistry practice. So it was possible to conclude that the smile considered aesthetically more pleasant for the interviewers had the following characteristics: intermediate incisal plane between the straight and the smile line, gingival harmonic level, absence of midline deviation, absence of diastema, and A1 shade (AU).

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Abstract The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

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A adequada estética do sorriso é cada vez mais almejada pelo paciente e pelo profissional. Dentes escurecidos e com lesões de abfração, causadas por excessiva carga oclusal, desfavorecem o agradável aspecto dos dentes e a estética facial como um todo. Este caso clínico relatou o procedimento restaurador de dentes anteriores superiores que apresentavam cor e forma inadequadas. Foram confeccionadas facetas e coroas com cerâmica termoprensada reforçada por dissilicato de lítio (IPS e.max Press, Ivoclar), que tem sido frequentemente utilizada na confecção de restaurações em dentes anteriores e posteriores por apresentar propriedades estéticas e mecânicas satisfatórias. Após a reabilitação, pôde-se perceber que o detalhado planejamento do tratamento e a correta escolha do material restaurador resultaram no restabelecimento funcional e estético. Foi possível concluir que restaurações obtidas a partir da cerâmica de dissilicato de lítio mostraram ser uma ótima alternativa para a confecção de facetas e coroas, considerando que houve perfeita concordância de cor entre ambas as restaurações, resultando no sucesso do tratamento e satisfação do paciente.

Adequate aesthetic appearance of the smile is increasingly desired by patient and professional. Darkened teeth and abfraction injuries caused by excessive occlusal load jeopardizes the appearance of the teeth, and the facial aesthetics as a whole. This case describes the restorative treatment of upper anterior teeth that presented inadequate color and form. Crowns and laminate veneers were made with lithium disilicate ceramic, which has often been used in the fabrication of anterior tooth restorations because it presents satisfactory aesthetic and mechanical properties. After the restorative process, it can be concluded that the detailed treatment planning and the correct choice of restorative material result in the reestablishment of function and aesthetics. It was concluded that the lithium disilicate ceramic showed to be an excellent alternative for making laminate veneers and adjacent crowns, considering that there was perfect color matching between both restorations, resulting in the success of treatment and patient satisfaction.

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