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OBJECTIVE: This study evaluated the microshear bond strength of a resin cement to Y-TZP after different methods of TiO2 nanotubes (nTiO2) incorporation on pre-sintered Y-TZP surfaces. METHODS: nTiO2 were synthesized and incorporated on Y-TZP slices as follows (n = 15): 1) nTiO2 mixed with isopropyl alcohol/manual application (MAl); 2) nTiO2 mixed with acetone/manual application (MAc); 3) nTiO2 mixed with isopropyl alcohol/high-pressure vacuum application (HPVAl); 4) nTiO2 mixed with acetone/high-pressure vacuum application (HPVAc). As controls, surfaces were sandblasted with Al2O3 (OX) or Rocatec silicatization (ROC). All ceramics were sintered after nTiO2 incorporation. Surface treatments of OX and ROC were made after sintering. Surfaces were characterized by confocal laser microscopy, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Resin composite cylinders (1.40 mm diameter and 1 mm height) were cemented with a resin cement, stored in water at 37 °C for 24 h and thermocycled for 10 000 cycles before microshear bond strength evaluation. Data were analyzed with one-way ANOVA and Games-Howell (α = 0.05), and fracture analysis was performed using a stereomicroscope. RESULTS: EDS confirmed the presence of TiO2 on treated Y-TZP. The confocal analysis showed higher roughness for HPVAc and OX. There were significant differences between surface treatments (p < 0.001). HPVAl (22.96 ± 10.3), OX (34.16 ± 7.9) and ROC (27.71 ± 9.4) showed higher microshear bond strengths and were statistically similar (p > 0.05). MAC showed intermediary values, and HPVAc and MAl presented decreased bond strength, with a high percentage of premature debonding. CONCLUSION: High-pressure vacuum application of nTiO2 mixed with isopropyl alcohol was able to produce bond strength values compared to conventional air abrasion and Rocatec silicatization. SIGNIFICANCE: The infiltration of TiO2 nanostructures on the pre-sintered Y-TZP is an interesting approach that can improve bond strength without the need of sandblasting methods.

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Background: Proanthocyanidin has been considered as a preventive agent against erosion because of its properties, which involves remineralization, reduction of demineralization and matrix metalloproteinases (MMPs) inhibition. Thus, the aim of this in situ study was to evaluate the effect of proanthocyanidin-based dentifrices on wear resistance of dentin specimens subjected to erosion associated with abrasion. Material and Methods: This crossover double-blinded study was performed in 5 phases of 5 days each, with 10 healthy volunteers who wore 5 palatal devices (1 for each phase) with 4 dentin specimens. The groups under study were: G1 - placebo dentifrice (negative control group); G2 - 0.012% chlorhexidine dentifrice (1st positive control group); G3 - NaF 1110 ppm fluoride dentifrice (2nd positive control group); G4 - 10% purified proanthocyanidin dentifrice (1st test group); G5 - fluoride + proanthocyanidin dentifrice (2nd test group). Erosion was performed by palatal device immersion in acid beverage (Coca-cola®), 3 times daily for 5 minutes during 5 days. Abrasion was applied after the first and third erosive cycles by using a eletric toothbrush during 15 seconds in each specimen with the application of the studied dentifrices slurry. The response variable was depth of dentin loss (µm) measured by profilometry. Data were analyzed by Repeated Measures Analysis of Variance followed by LSD Fisher's test (p<0.05). Results: Data (G1: 1.76 ± 0.55A; G2: 1.19 ± 0.42B; G3: 1.29 ± 0.34B; G4: 0.93 ± 0.38C; G5: 0.82 ± 0.34C) showed that G4 and G5 did not presented significant difference between them, but showed less dentine loss when compared to all other groups. G1 presented the highest dentin wear. Conclusions: Proanthocyanidin and the combination of proanthocyanidin and fluoride dentifrices revealed the best results, showing that these formulations could be a promising alternative for patients who suffer with dentin erosion. Key words:Dentin, erosion, cross-liking agent, metalloproteinases, toothpastes.

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STATEMENT OF PROBLEM: Intraoral scanners (IOSs) have some inherent distortions caused by optical and/or software imperfections. However, how other factors such as operator experience, scan time, scanner type, and scan size influence scan accuracy is not clear. PURPOSE: The purpose of this in vitro study was to evaluate the trueness and precision of scans performed by 3 professionals with different levels of experience by using 2 IOSs. MATERIAL AND METHODS: Three operators with low, medium, and high levels of experience scanned a master model 10 times by using 2 IOSs (CEREC Omnicam; Dentsply Sirona and TRIOS 3; 3Shape), resulting in 10 standard tessellation language files for each group (N=60). Each standard tessellation language file was divided into 2 areas (prepared teeth and complete arch). Precision was evaluated by comparing the 10 scans from each examiner for each system. Trueness was evaluated by comparing each scan file with a reference scan obtained from a laboratory scanner (D2000; 3Shape). A 3D analysis software program (Geomagic Control; 3D Systems) was used to perform all the comparisons and superimpositions. The 3-way ANOVA test followed by the Tukey HSD test were used to assess precision and trueness. The 2-way ANOVA followed by the Tukey HSD test was used to assess scan time. The Pearson correlation test was performed between scan time and trueness for both scanners. An additional correlation was performed between scan time and number of images, as well as between number of images and trueness for the TRIOS 3. RESULTS: Statistically significant influences of operator (P<.001), scanner (P<.001), scan size (P<.001), operator and scan size (P<.001), and scanner and scan size (P<.001) were observed. The TRIOS 3 group reported higher precision than the CEREC Omnicam group for complete-arch scans (P<.001), although no difference was observed for scans of the prepared tooth. Medium- (P=.002) and low-experience operators (P<.001) reported lower precision for complete-arch scans performed with CEREC Omnicam when compared with TRIOS 3. The low-experience operator reported significantly worse results for complete-arch scans in comparison with the medium- (P=.008 and P<.001) and high-experience operators (P<.001 and P=.001), by using TRIOS 3 and CEREC Omnicam, respectively. Medium- and high-experience operators reported similar results among themselves. The CEREC Omnicam scanner reported lower trueness for complete-arch scans when compared with the prepared tooth (P<.001); for TRIOS 3, a difference was only observed for the low-experience operator when compared with the high-experience operator (P<.001). The CEREC Omnicam reported lower trueness than the TRIOS 3, except for the medium-experience operator with the prepared tooth scan. Comparing the trueness between operators and considering the same scanner and scan size, all groups were similar. The low-experience operator had a longer scanning time than the medium- and high-experience operators. For TRIOS 3, the low-experience operator obtained the highest number of images during each scan. CONCLUSIONS: The accuracy of intraoral scans was influenced by operator experience, type of IOSs, and scan size. More experienced operators and smaller scan sizes made for more accurate scans. In addition, more experienced operators made faster scans, and the TRIOS 3 was more accurate than the CEREC Omnicam for complete-arch scans.

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STATEMENT OF PROBLEM: Information related to the optical and surface properties, including health compatibility, surface roughness, and esthetics, of 3D-printed dental materials is scarce. PURPOSE: The purpose of this in vitro study was to compare the physical and surface properties of a 3D-printed resin with those of materials used for interim restorations. MATERIAL AND METHODS: A 3D-printed resin (PR) (NextDent C&B MFH; 3D Systems), an autopolymerizing interim material (BA) (Protemp 4; 3M ESPE), and a composite resin (Z350) (Filtek Z350XT; 3M ESPE) were tested for degree of color change (ΔE) (n=7) at different timepoints-24 hours after polishing/baseline (P0), 8 days after polishing (P1), and after artificial aging in water at 60 °C for 24 hours (P2)-by using a CIELab-based colorimeter; flexural strength (σ) (n=10) with a 3-point bend test; Knoop hardness (H) (n=8); and surface roughness (Ra) (n=7) with a profilometer. All specimens were polished 24 hours after polymerization, except for the additional group for surface roughness (BA) without polishing (BANP). A statistical analysis was performed by using 2-way repeated-measures ANOVA followed by the Fischer test for ΔE and 1-way ANOVA followed by the Fisher test for microhardness and surface roughness (α=.05). RESULTS: The Z350 showed the highest values for σ and H, followed by PR. BA showed the lowest results for both tests (P<.05). Considering roughness, the Z350 showed similar values to those of BA but lower than PR; PR showed similar roughness when compared with BA. PR showed the highest color variation among the groups at all timepoints, followed by BA. The Z350 was the most color stable material at all timepoints. CONCLUSIONS: The 3D-printed composite resin had adequate mechanical and surface properties for an interim restorative material. It has the potential to be a low-cost workflow in dentistry, although its color stability could be a concern for long-term use.

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Aim: To evaluate the color stability of bovine enamel with artificial white spot lesions treated with resin infiltration (ICON) or remineralization with fluoride using two storage methods. Methods: Sixty incisors were submitted to artificial white spot lesion induced by demineralization-remineralization (DE-RE) cycling. Initial color was evaluated with CIE-Lab to measure ΔEab. Demineralized teeth were divided according to the treatment of the white spot lesion (n = 20): 1) Remineralization with 2% neutral fluoride gel for 4min (control); 2) ICON application following manufacturer's recommendations; and 3) ICON with decreased drying time after the application of ethanol. After 24h, color was evaluated and samples were subdivided (n = 10) according to storage: 1) distilled water for 1 month; 2) grape juice for 10min daily. After storage, color was evaluated. L*, a* and b* data were analyzed by one-way ANOVA and ∆Eab data by two-way ANOVA followed by Tukey's HSD (α = 0.05). Results: L* was affected by juice storage, and decreased when ICON was applied with decreased drying time after the ethanol application. The same behavior occurred with a* (increase with reduced drying time), while b* was not affected. For ∆Eab significant differences were observed between groups (p = 0.0219) and storage methods (p = 0.0007). There was no interaction effect (p = 0.1118). Remineralization with fluoride presented the lowest color changes after storage in water. Conclusion: Treatment of artificial carious lesions with resin infiltration presented greater color changes than fluoride remineralization after storage in both solutions in vitro

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OBJECTIVE: Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. OBJECTIVE: This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. METHODOLOGY: Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). RESULTS: Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. CONCLUSIONS: Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

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Bulk-fill composites were introduced in dentistry to accelerate clinical procedures while providing adequate outcomes. Concerns regarding the use of bigger composite increments rely on the polymerization shrinkage and shrinkage stress, which may generate gaps on the adhesive interface and result in a reduced success rate. OBJECTIVE: To evaluate the polymerization shrinkage stress of different bulk-fill resin composites and their elastic modulus. MATERIALS AND METHODS: Fourteen specimens were made for each of the nine different resin composites (seven with 12 mm3 and seven with 24 mm3): Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), Filtek Z350XT Flow (Z3F); Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Xtra Fusion (ADM) and Filtek Z350 XT (Z3XT). Linear shrinkage stress was evaluated for 300 s with the aid of a linear shrinkage device adapted to a Universal Testing Machine. For each composite group, seven additional specimens (2x2x25 mm) were made and Young's modulus was evaluated with a 3-point bending device adapted in a Universal Testing Machine with 0.5 mm/min crosshead speed and 50 KgF loading cell. RESULTS: For 12 mm3 specimens, three-way ANOVA showed that only SDR and TBF generated lower stress after 20 s. Considering 300 s, TBF, SDR, and XF generated the lowest stress, followed by ADM, FBP, XB, and FBF, which were similar to Z3XT. Z3F generated the highest stress values for all time points. Considering 24 mm3 specimens after 20 s, all bulk fill composites generated lower stress than Z3XT, except XB. After 300 s, SDR, FBP, and ADM generated the lowest stress, followed by TBF and XF. For elastic modulus, one-way ANOVA showed that FBF, SDR, Z3F, and ADM presented the lowest values, followed by XB and TBF. FBP, Z3XT, and XF presented the highest elastic modulus among the evaluated composites. CONCLUSIONS: Bulk-fill resin composites presented equal to lower shrinkage stress generation when compared to conventional composites, especially when bigger increments were evaluated. Bulk-fill composites showed a wide range of elastic modulus values, but usually similar to "regular" composites.

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Abstract Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. Objective This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. Methodology Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). Results Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. Conclusions Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

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BACKGROUND: The use of hybrid-light (HL) during in-office teeth bleaching can provide faster and reliable results after a single bleaching session, especially if associated with previous acid etching. The present in vivo, interventional, split-mouth, triple-blinded and randomized study evaluated the efficiency of a HL, with and without prior enamel acid etching, assessing the gel application time, degree of color change, sensitivity and treatment stability up to 12 months. METHODS: Thirty-four patients were selected and randomly divided into four groups. The color was evaluated using a spectrophotometer with the CIELab color system, and a VAS questionnaire was used to evaluate the sensitivity. Both upper and lower hemiarches (GI and III) received enamel acid etching with 37% phosphoric acid for 15 s prior to the application of 35% hydrogen peroxide gel (HP). For GI and II, HP was applied on both dental arches for 3-4 consecutive applications and activated by HL (2 × 3' activations with 1' interval); and 3 × 15' (HP) for GIII and IV without HL. Patients returned in 24 h, 1 week, 1-, 6- and 12-months intervals. The clinical operator was different from the clinical measurements operator. RESULTS: After 3-way ANOVA, Tukey's, Wilcoxon and Mann-Whitney tests, all with p < 0.05, no statistical differences were observed between the groups regarding color change (ΔE) and sensitivity in all evaluations. The lowest gel application time was observed for GII (acid etch + HL), followed by GI (HL). CONCLUSIONS: The present study's results reveal the advantages of HL associated with acid etching prior to in office bleaching.

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PURPOSE: To evaluate the color change caused by post-irradiation conversion (ΔE24h and ΔE8 days ) and artificial aging (ΔEAGING ) of resin cements light activated through ceramics of different opacities immediately and 6 minutes after manipulating the material. MATERIALS AND METHODS: Resin cement disks (Allcem and LuxaCore) were light activated through ceramics (without ceramic, e.max HT, LT, and MO) immediately and 6 minutes after the manipulation (n = 10). Spectrophotometry was used to evaluate ΔE24h and ΔE8 days after 37˚C-dry-dark-storage for 24 hours and 8 days, and ΔEAGING after 60˚C-water-storage for 24 hours. Data were analyzed with three-way ANOVA and Tukey's HSD (α = 0.05). RESULTS: Regarding the post-irradiation color change, significant differences were found between the cements (p < 0.0001), light activation protocols (p = 0.037), and ceramics (p < 0.001). The immediate activation (16.2 ± 0.1) showed lower ΔE values than the delayed activation (16.5 ± 0.1). Ceramics influenced the ΔE values as follows: MO (14.0 ± 1.2) < LT (14.9 ± 1.2) ≈ HT (15.4 ± 1.2) < control (21.2 ± 1.2). Regarding ΔEAGING , significant differences were found between cements (p < 0.001), light activation (p = 0.006), and ceramics (p < 0.001). The delayed activation (8.4 ± 0.1) showed lower values than the immediate activation (8.9 ± 0.1). Ceramic spacers influenced ΔEAGING as follows: control (5.6 ± 0.2) < MO (6.6 ± 0.2) < HT (11.0 ± 0.2) ≈ LT (11.5 ± 0.2). CONCLUSION: The delayed light activation resulted in increased color stability, while the ceramic interposition resulted in lower color stability.

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A pigmentação melânica gengival é uma condição clínica mais prevalente em indivíduos da raça negra e oriental, consistindo frequentemente em um problema estético. Embora a recidiva seja imprevisível, vários tratamentos são propostos, entre eles a mucodermoabrasão com diferentes instrumentos. O objetivo do presente relato de caso clínico foi demonstrar duas técnicas para resolução desses casos: emprego dos gengivótomos e de uma ponta de cerâmica em alta rotação.

Gingival melanin pigmentation is a clinical condition, more prevalent in oriental and black people, and may generate esthetical problems. Despite the fact that recurrence is unpredictable, different treatments are proposed, such as epithelial abrasion with different instruments. The objective of the present case report is to show two different techniques for resolution of such cases: use of Kirkland periodontal knife, and abrasive ceramic burs in high speed.

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Introduction: Fractures of the anterior teeth consists of a clinical condition that generates not only aesthetic and psychological problems, but may also cause dental pain. Thus, the affected teeth should be treated as urgencies in dental offices and their resolution whenever possible should be in a single session. Direct resin composite restorations should wherever possible be preferred due to the speed and possibility of obtaining good results. Objective: The objective of this case report is to describe the clinical sequence for restoration of a maxillary central incisor that presented a crown fracture using an immediate insert technique for resin composite (a "free hand" technique) with a modification to obtain dentin layer. Case report: A patient sought treatment after she fractured tooth #21. The restoration was performed with resin composite using the immediate technique. To facilitate the layering technique, the immediate insertion technique was changed for making the dentin lobes with the aid of a Teflon tape and the support with the index finger. Conclusion: The restoration of fractured anterior teeth can be performed quickly with the use of resin composites of different opacities and the use of the technique of immediate insertion proposed in this case report.

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Restaurações livres de metal (metal free) têm se tornado bastante populares devido à evolução dos materiais e das técnicas de preparo e cimentação, associando adequadas propriedades físico-mecânicas e estéticas com resultados satisfatórios a longo prazo. O uso de pastas de teste (pastas try-in) e cimentos fotopolimerizáveis facilitam a técnica de cimentação. O objetivo do presente relato de caso clínico é demonstrar uma sequência de restabelecimento estético do sorriso com restaurações metal free, empregando um protocolo previsível (AU).

Metal free restorations have became very popular due to materials and preparation and cementation techniques evolution, associating adequate physico-mechanical and esthetics properties with adequate long term results. The use of try-in pastes and light curing cements facilitates the cementation technique. The objective of the present case report is to show a sequence of smile aesthetic rehabilitation with metal free restorations, using a predictable protocol (AU).

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Abstract The cementation of thin ceramic veneers employing fluid light-activated resin-based materials is a common procedure in the dental practice. Aim: To evaluate the influence of ceramic thickness and shade on the degree of conversion (DC) of a flowable light-activated material. Methods: flowable resin composite (Tetric N-Flow - shade A1) was light-activated through ceramic discs of two shades (IPS Classic - A1 and A3) in three thicknesses (0.5, 0.7 and 1.0 mm). For control, the resin composite was light-activated without ceramic interposition. DC was evaluated by FTIR (n=5). Data were analyzed by one-way ANOVA and Dunnett's T3 test (α=0.05). Results: Statistically significant differences between groups were observed (p<0.001). Control group (without the interposition of ceramic) showed the highest mean for DC (71.9± 1.7). Considering the interposed ceramic disc groups, the highest DC values were obtained when 0.5 and 0.7 mm A1 ceramics were used (64.6±1.2 and 64.4 5.0, respectively) and the lowest DC values were obtained for 0.7 and 1 mm A3 ceramics (61.74±0.9 and 62.0±1.9, respectively). Conclusions: No flowable resin composite group with interposing ceramics reached a DC similar to the control group.

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Introduction:Stone casts are used in dentistry to allow the confection of indirect restorations. Thus, gypsum dimensional stability is fundamental in order to achieve a precise fit between dental structure and restorative material.Objective: The purpose of the present study was to evaluate the hygroscopic linear expansion of commercially available gypsum products. Material and methods: Fifteen dental stones were analyzed (4 type II, 5 type III, 4 type IV and 2 type V), with n = 5. One hundred grams of each gypsum product were mixed following the respective manufacturers' recommendations for powder/water ratio and poured into a V-shape mold, connected to an expansion-measuring device. The hygroscopic expansion was evaluated during 120 min and the collected data was converted into percentage and compared to initial dimensions of the specimen. Results: All type II and V dental stones showed expansion values compatible to the ADA and ISO recommendations. Considering type III stones, only Rutenium 3 was compatible with the recommendations. For type IV, only Durone IV showed expansion values higher than that recommended by ADA, but lower than that of ISO recommendations.Conclusion: The hygroscopic linear expansion of gypsum products should be periodically controlled in order to ensure their precision and reliability to dental practice.

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Introduction:Due to its chemical, mechanical and biological properties, the glass ionomer cements (GIC) consist in one of the most versatile direct restorative materials, with many potential clinical indications, especially in the context of minimally invasive dentistry. Nevertheless, they have some limitations and require the knowledge of their characteristics and procedures of application in order to achieve their maximum potential.Objective: To demonstrate through literature review the main characteristics, indications, limitations and future perspectives for the use of GIC. Literature review: The database, such as Pubmed and Lilacs were used. Additionally, books were also evaluated and included. Conclusion: The GIC is in constant evolution and is one of the materials that are best suited in the context of preventive and conservative dentistry. It has satisfactory properties and versatility. On the other hand, presents inferior properties when compared to other direct restorative materials, requiring caution during its handling.

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OBJECTIVE: Tooth bleaching tends to increase enamel roughness and porosity, in addition to reducing surface microhardness. The aim of this in vitro study was to evaluate the effects of bleaching treatments using different hydrogen peroxide (HP) concentrations, with and without light activation on bovine enamel microhardness. MATERIALS AND METHODS: The buccal surfaces of sixty bovine incisors were flattened and polished and the enamel specimens were divided into six groups: G1 : c0 ontrol, exposed to artificial saliva; G2: 35% HP applied in two sessions (45' each); G3: 35% HP applied in two sessions (3 × 15' each); G4: 35% HP applied in one session (3 × 7'30") plus hybrid light (HL); G5: 25% HP applied in one session (3 × 7'30") plus HL; and G6: 15% HP applied in one session (3 × 7'30") plus HL. After the treatment, the enamel specimens were stored in artificial saliva. The surface microhardness (Knoop) was measured at the baseline, 24 h and 7 days after bleaching. The data was analyzed using the ANOVA test, followed by the Tukey-Krummer test (P < 0.05). RESULTS: All bleaching procedures lead to a decrease in surface microhardness when compared with the control group after 24 h. The lowest change in surface microhardness was found in the specimens treated with 15% HP plus HL. However, 35% HP plus HL induced the highest decrease in surface microhardness. After 7 days of remineralization, the surface microhardness returned to normal levels for all bleached specimens. CONCLUSION: Therefore, it can be concluded that the bleaching protocols caused a slight enamel surface alteration. However, the remineralization process minimized these effects.

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Entre os tipos mais frequentes de restaurações dentárias, destacam-se as restaurações dos tipos compostas e/ou complexas em dentes posteriores, sendo comum a perda de uma ou mais cúspides, necessitando de uma abordagem multidisciplinar. No contexto atual da Odontologia minimamente invasiva, as resinas compostas têm destaque importante, pois possibilitam a substituição de restaurações insatisfatórias sem sacrificar excessivamente as estruturas dentárias sadias. Esta característica importante permite a realização de restaurações extensas em dentes desvitalizados. Este relato de caso clínico objetiva descrever uma técnica restauradora de um dente posterior envolvendo uma abordagem multidisciplinar (periodontia, endodontia e dentística restauradora), apresentando e discutindo a sequência dos procedimentos adotados. Neste caso clínico foi realizada uma cirurgia periodontal com intuito de possibilitar a posterior restauração direta em resina composta, associada a um retentor intrarradicular reforçado com fibra de vidro. Dessa forma, com a evolução das técnicas e materiais disponíveis para os clínicos gerais e especialistas, esta abordagem possibilita a devolução da estética e da função em um pequeno número de sessões clínicas, com custo reduzido quando comparado aos tratamentos restauradores indiretos.

Complex or composite posterior teeth restorations are among the most common types, and the loss of one or more cuspids is very frequent and often requires a multidisciplinary approach. Within the context of minimally invasive Dentistry, composite resins are widely used since they allow the replacement of unsatisfactory restorations, avoiding excessive wear of the healthy tooth structure. This enables extensive restorations in devitalized teeth. This report aims to describe a restoration technique applied on a posterior tooth through multidisciplinary approach (periodontics, endodontics and restorative dentistry), presenting and discussing the adopted procedures. In this clinical case, a periodontal surgery was performed in order to allow the subsequent direct composite resin restoration associated with an intra-radicular fiber post. Thus, with the evolution of techniques and materials available to the general practitioner and specialists, direct restorations allow aesthetical and functional restoration with a small number of clinical sessions with a lower cost when compared to indirect restorations.

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problem at dental offices and new approaches may be developed. Objectives: The authors studied different desensitizing treatments and their efficacy in reducing dentinal permeability and dentinal tubules opening. Material and methods: One hundred bovine incisors roots had their buccal surface flattened and treated by 3 applications of each desensitizing agent, following the respective groups (n = 10). After treated, 7 specimens of each group were prepared for a 0.5% basic fuchsin permeability test and the other 3 specimens were prepared to SEM qualitative analysis. The permeability test specimens were sectioned with a diamond saw in order to evaluate the stained and unstained areas. Kruskall Wallis statistical analysis was performed (p < 0.05). Results: Colgate Pró-Alívio paste and toothpaste, diode and Nd:YAG Lasers, GHF, Sensi Active, Oxagel and 2% Desensibilize promoted a significant permeability reduction when compared with the respective control groups (p < 0.05). Comparing the mean permeability differences between the different groups after the treatments, Oxagel and Nd:YAG were better than 0.2% Desensibilize group. Conclusion: None of the treatments may be considered 100% effective in treating dentinal hypersensitivity since a partial reduction of the permeability was observed.

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Introduction: Often, dentists perform procedures aiming at more esthetical than long-term clinical performance of restorations. Objective: To evaluate the prevalence of use of different direct and indirect restorative materials in posterior teeth. Material and methods: In 2004, a questionnaire was applied to 486 dentists living at five geographical regions of Brazil. The dentists answered a questionnaire containing four questions, in which they reported the most widely used restorative material for direct (amalgam, composite resin, and glass ionomer) and indirect restorations (gold, silver, and copper/aluminum alloys, indirect resin composites, and ceramics) and specified the reason for using the material type selected. Results: In 2004, amalgam was the direct restorative material most used by dentists at almost all regions, except from South region, where resin composite was the most used. Esthetics was the main reason stated for the use of resin composites. As for indirect restorations, metallic restorations were the most used in Northeast (77.8%). No differences were found regarding the material type use between metallic and aesthetic materials at North, Southeast and Center-West regions. At South region, esthetic restorations were the most used. Conclusion: Despite the limitations of this present study, direct and indirect metallic restorations were the most common materials in 2004.