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OBJECTIVE: Evaluate the color and translucency of a nanoceramic resin subjected to hygiene practices and immersion in coffee over time. MATERIALS AND METHODS: Specimens (n = 80, HT and LT, 0.5-mm thick) of a nanoceramic resin were obtained and were divided in groups according to the simulated oral hygiene: no intervention (NT), brushing with an electric brush and water (BN), brushing with an electric brush and toothpaste for 10 s (BT), and immersion in mouthwash for 30 s (MW). Oral hygiene practices were repeated after staining in coffee solution for 15, 48, 336, 1440, 8640, and 35,040 min. Spectral wavelengths were recorded with a spectrophotometer at each time. ∆E00, ∆L', ∆C', ∆H', and TP00 were calculated by CIEDE2000 and were evaluated by 2-way ANOVA, repeated measures ANOVA, and Tukey's HSD test (α = 0.05). RESULTS: ANOVA showed significance among factors for ΔE00 (p < 0.05), with higher ΔE00 for NT-HT (11.7) and NT-LT (11.2). After T6 (2-year simulation), the lowest values were found for BT-HT (5.3) and BT-LT (4.9). All groups showed a reduction in lightness and translucency and increased chroma and hue. However, the smallest variations were found in the BT groups (p < 0.05). CONCLUSIONS: Brushing with toothpaste effectively minimized the color change of NCRs caused by coffee staining. CLINICAL SIGNIFICANCE: Oral hygiene practices, such as brushing with toothpaste, might be important to minimize staining of nanoceramic resin restorations, especially in patients who frequently consume coffee.

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Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.

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Abstract Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. Objective This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. Methodology A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). Results For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). Conclusions The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.

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OBJECTIVES: To assess the discoloration of teeth treated with the different phases of calcium aluminate cement (CAC), in comparison with the conventional CAC and mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Fifty bovine incisors were prepared and filled. Two millimeters of the filling was removed to fabricate a cervical plug with the following cements (n=10): CA(CaO.Al2 O3 ); CA2 (CaO.2Al2 O3 ); C12 A7 (12CaO.7Al2 O3 ); CAC and MTA. The initial color measurement was performed and after 7, 15, 30, 45, 90, 180, and 365 days new color measurements were performed to determine the color (ΔE00 ), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and the whiteness index (WID ). RESULTS: ΔE00 was significant for groups (p = 0.036) and periods (p < 0.05). The greater ΔE00 was observed after 365 days for CAC (12.8). C12 A7 (7.2) had the smallest ΔE00 . ΔL' and ΔC' were significant for groups and periods (p < 0.05). ΔH' was significant for periods (p < 0.05). After 365 days, significant reduction in lightness was observed for all groups. For CA, CA2 , CAC, and MTA groups, the WID values decreased over time (p < 0.05). CONCLUSIONS: The tested cements changed the color behavior of the samples, resulting in greater teeth darkening over time. CLINICAL SIGNIFICANCE: There is no long-term study assessing the discoloration induced by the different phases of CAC.

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Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.

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OBJECTIVE: Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional restorative treatment. Noninvasive treatments, that are in accordance with the patients' expectations, should be the first therapeutic alternative. If the deciduous tooth is present, minimally invasive dental extraction followed by immediate dental implant placement and provisional restoration is indicated. In this restorative treatment, an adequate emergency profile can be achieved by peri-implant soft-tissue-conditioning techniques. Moreover, the association of restorative materials, such as composite resins and dental ceramics, provides more predictable esthetic results. CLINICAL CONSIDERATIONS: The present case report presents a rehabilitation of bilateral congenital absence of maxillary lateral incisors through a multidisciplinary approach. Dental implants, long-term provisional restoration, tooth bleaching, minimally veneered high-translucent monolithic zirconia crowns, feldspathic veneers, and composite restorations were used by the dental team to achieve the expected functional and esthetic outcomes. CONCLUSIONS: Different treatment modalities are available for the rehabilitation of congenital absence of teeth. However, it is important that a dental team consider performing minimally invasive treatments, as many of these treatments are done on young patients. CLINICAL SIGNIFICANCE: Patient-centered treatments involving minimally invasive approaches in a multidisciplinary environment would be appropriate in order to achieve predictable results.

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OBJECTIVE: This review integrates published scientific information about the fluorescence of natural teeth, dental resins and ceramics, and the main methods of analysis and quantification presented in the literature. OVERVIEW: Fluorescence is an emission of light (photons) by a substance that has absorbed light of higher energy. In natural teeth, it is more intense in the dentin than in the enamel and presents a bluish-white color. In dental resins and ceramics, fluorescence is obtained by the incorporation of materials that contain rare-earth luminescence centers (more precisely lanthanide luminescence centers), which allows these artificial materials to simulate natural teeth in a more beautiful and vital-looking way. However, the lack of knowledge about this optical phenomenon on the part of professionals indicates the need for more scientific studies and dissemination on this topic. CONCLUSIONS: Aesthetic materials have variable spectral compositions and fluorescence intensities, which are not always compatible with natural teeth. The fluorescence of teeth and restorative materials can be influenced by several factors, such as aging, temperature, and bleaching. Several devices for fluorescence evaluation and quantification are used in studies under different methodologies, but the small number of studies on the subject make it difficult to compare their results. CLINICAL SIGNIFICANCE: Fluorescence is a fundamental optical property for aesthetic rehabilitations since its presence and intensity in the restorative materials allows achieving an aesthetic result much closer to reality. However, the fluorescent behavior of natural teeth and aesthetic restorative materials is not yet fully understood by researchers and clinicians. Greater understanding of this phenomenon will contribute to the selection, indication, and clinical use of these materials.

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BACKGROUND: Different disinfectant solutions or medications are indicated prior fiber post bonding procedures.The aim was to evaluate the effect of different pretreatments of root canal on the bond strength of a fiber post luted to dentin with self-adhesive resin cement. MATERIAL AND METHODS: Forty-eight single-rooted mandibular premolars were endodontically treated and prepared to receive fiber posts. Teeth were assigned to four groups (n=12). Root canal walls were subjected to no pretreatment (G1 - control); irrigation with 10 mL of 5% sodium hypochlorite (NaOCl) (G2); 10 mL of 17% ethylenediaminetetraacetic acid (EDTA) associated with 10 mL of 5% NaOCl (G3); or 10 mL of 17% EDTA (G4). Fiber posts were bonded with self-adhesive cement. After the roots were sectioned into slices, a push-out bond strength test was performed using a universal testing machine at crosshead speed of 0.5 mm/min. Bond strength data were recorded and expressed in MPa and analyzed by Anova (5%) and Tukey Test (5%). RESULTS: It was found that G2 (9.36 MPa) and G4 (6.33 MPa) were significantly different among themselves and statistically inferior to G1 (13.93 MPa) while G3 (14.31 MPa) was statistically similar to G1 (control) and superior to G2 and G4. CONCLUSIONS: Irrigation with 17% EDTA associated with 5% NaOCl showed increased bond strength compared with the same solutions used alone. Key words:Self-adhesive, Dentin, Push-out, Bonding.

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O planejamento é fundamental na Implantodontia. Com um correto planejamento, tornam-se muito maiores as chances de obtenção do sucesso clínico, que hoje vai muito além de somente alcançar a osseointegração dos implantes, mas sim, de posicionar o implante idealmente para a confecção de uma prótese que venha a contemplar saúde, função e estética. O objetivo desse artigo foi de reforçar a importância das etapas de planejamento e da utilização de meios para transferir as informações obtidas para a situação clínica através do uso de guias. A busca pelas publicações foi realizada nas bases de dados Pubmed (Medline) e Periódicos CAPES, durante o segundo semestre de 2013. Também foi realizada busca manual de referências. A seleção final após a leitura de títulos, abstracts e textos completos chegou a 30 artigos. Concluiu-se que os guias auxiliam em todas as fases do tratamento e permitem maior previsibilidade dos resultados, aumentando substancialmente a qualidade e longevidade das reabilitações protéticas implantossuportadas.

Planning is essential in oral Implantology. With correct planning there are greater chances of obtaining clinical success, which currently means more than the osseointegration of implants, and includes ideal positioning of the implant for making a prosthesis that contemplates health, function and aesthetics. The aim of this article was to reinforce the importance of planning steps and the use of means to transfer the information obtained to the clinical situation using the guides. The search was conducted in the databases Pubmed (Medline) and CAPES journals during the second half of 2013. It was also performed manual search of references. The final selection after reading titles, abstracts and full texts reached 30 articles. It can be concluded that the guides help at all stages of treatment and allow greater predictability of the results, thereby greatly enhancing the quality and longevity of the prosthetic implant restorations.

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OBJECTIVE: The aim of this paper is to report a clinical case of nasal floor elevation and simultaneous dental implant placement. CASE REPORT: The patient presented to the clinic of the Center of Education and Research on Dental Implants (CEPID) in the Department of Dentistry at the Federal University of Santa Catarina (UFSC, Florianópolis, Brazil), for follow-up for peri-implantitis control. After clinical and radiographic assessment, two of three implants on anterior maxilla were removed. A cone beam computed tomography (CBCT) scan revealed no bone height for conventional length implant insertion. Nasal floor elevation and simultaneous implant placement were performed, with nasal cavity augmentation carried out with bovine bone graft. After six months, the implants were reopened successfully. CONCLUSIONS: Nasal floor elevation proved to be a reliable method for dental implants insertion on the anterior atrophic maxilla when bone height reconstruction was necessary. The use of bovine bone substitutes for nasal cavity augmentation showed predictable results as well as simultaneous implant placement.

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Objetivo: Avaliar os valores de torque de remoção em abutments parafusados após aplicação de diferentes técnicas de torque. Materiais e Métodos: Trinta espécimes de implante hexágono externo, abutment pré-fabricado e parafuso de titânio foram distribuídos randomicamente em três grupos. No grupo 1, os parafusos receberam um torque de 30 N.cm; no grupo 2 receberam um torque de 30N.cm e um segundo torque após 10 min, de acordocom a técnica proposta por Brending et al. e Dixon et al.; no grupo 3, um torque de 30 N.cm foi aplicado e mantido por 20 s, de acordo com a técnica recomendada por Sella et al. Os espécimes foram inseridos na máquina de teste universal e uma chave digital foi acoplada a célula de carga para controlar o valor de torque e a velocidade de 1N.cm/s. O torque de remoção foi realizado 10 min após o torque de aplicação. Os valores foramestatisticamente analisados usando 1-way ANOVA e Tukey HSD test (α = 0,05). Resultados: As médias e desvio padrão (±SD) dos valores de torque deremoção encontrados foram 27,95 ± 0,99N.cm para o grupo 1; 28,32 ± 0,68N.cm para o grupo 2 e 26,89 ± 1,03 N.cm para o grupo 3. Os grupos 1e 2 exibiram valores estatisticamente mais altos de torque quando comparados ao grupo 3 (p < 0,05).Conclusão: A técnica recomendada por Breeding et al. e Dixon et al. pareceu ser a melhor opção quando considerado os valores do torque de remoção de implantes hexágono externo.

Objective: To evaluate the removal torque values on abutment screws after different torque application techniques. Materials and Methods: Thirty specimens of an external hexagon implant, a prefabricated abutment and a titanium screw were distributed randomly in three groups. In group 1, the screws received a torque of 30N.cm; group 2 received a torque of 30N.cm and a second torque after 10 min, in accordance with the technique proposed by Brending et al. and Dixon et al.; in group 3, a torque of 30 N.cm was applied and maintained for 20 s, in accordance with the technique recommended by Sella et al. The specimens were attached to a universaltesting machine and a digital key was coupled to the load cell in order to control the torque value at a velocity of 1 N.cm/s. Removal torque was performed 10 minutes after torque application. Values were statistically analysed using one-way ANOVA and Tukey’s HSD test (α = 0.05). Results:The mean and standard deviations (±SD) of removal torque values found were 27.95 ± 0.99N.cm for group 1, 28.32 ± 0.68N.cm for group 2 and 26.89±1.03N.cm for group 3. Groups 1 and 2 exhibited statistically higher values of torque than group 3 (p < 0.05). Conclusion: The techniquerecommended by Breeding et al. and Dixon et al. seemed to be the best option when considering the removal torque values of external hexagonimplants

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Os tratamentos de carga imediata com implantes unitários em áreas estéticas apresentam alta previsibilidade e vem sendo uma ferramenta de grande valia para o implantodontista. Apresenta vantagens como a manutenção da arquitetura gengival e dimensão óssea, orientação para uma adequada cicatrização tecidual, estética imediata, conforto para o paciente e diminuição no tempo de edentulismo e de tratamento. Com o objetivo de facilitar o dia a dia do implantodontista, esse artigo descreverá, de maneira simples e didática, como reabilitar regiões anteriores com saúde e estética, e porque alguns cuidados tomados são fundamentais para manter a longevidade e o sucesso do caso (AU).

The immediate loading treatment with single implants in the aesthetic region has high predictability and it has been a valuable tool for implantologists. It has the advantage of maintaining gingival bone architecture and size, orientation for proper tissue healing, immediate aesthetic, and comfort for the patient as well as reduces edentulous period and the whole treatment period. In order to facilitate the routine of implantologists, this study will describe a simple and didactic way to rehabilitate aesthetic regions, and explain why proper care is determinant for the longevity and success of the case (AU).

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Este artigo descreve uma estratégia para criar substratos favoráveis do ponto de vista óptico antes da confecção de coroas cerâmicas. No caso clínico apresentado, a paciente foi tratada com núcleos estéticos e pilares para implantes que apresentam a mesma cor dos preparos vitais. Com essa abordagem é possível equalizar a cor do fundo, facilitar os procedimentos laboratoriais e otimizar o resultado estético...

This article describes a strategy to create favorable substrates from the optical point of view before making ceramic crowns. In the presented clinical case, the patient was treated with esthetic post and core and implant abutments with the same shade as the vital preparations. This approach enables to match the substrate shades, facilitate laboratory procedures, and optimize the aesthetic result...

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Este artigo procurou enfatizar a importância de se realizar uma adequada avaliação tecidual antes de iniciar reabilitações estéticas, além de sugerir possíveis condutas para restabelecer a arquitetura gengival. No caso clínico apresentado, os incisivos centrais superiores foram tracionados lentamente por aparatologia ortodôntica, visando nivelar o arco gengival e devolver a papila interdental. Após a obtenção de um quadro gengival mais harmônico, a forma dental foi restaurada com facetas cerâmicas para alcançar um bom resultado estético.

This article emphasizes the importance of adequate tissue assessment before starting aesthetic restorations, as well as to suggest possible guidelines to restore the gingival architecture. In the clinical case presented, the upper central incisors were orthodontically extruded, aiming to level the gingival arch and to retrieve the dental papillae. After obtaining a more harmonic gingival architecture, the dental form was restored with ceramic veneers to achieve good aesthetic result.

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A técnica aqui apresentada utiliza um guia cirúrgico que auxilia no posicionamento tridimensional de um implante imediato e, logo em seguida, facilita a confecção da coroa de transição. As referências preexistentes do elemento dentário são preservadas no guia cirúrgico, garantindo um resultado estético mais previsível...

The technique presented herein uses a surgical guide to assist tridimensional positioning of an immediate implant and subsequently provides ease for temporary crown manufacture. The preexisting tooth references remain unchanged in the surgical guide, which ensures more predictable esthetic outcomes....

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Avaliar, com o auxílio de tomografias computadorizadas, a disponibilidade óssea para a realização de cirurgias de instalação de implantes osseointegrados em função da localização do canal mandibular.Metodologia: trinta e duas tomografias computadorizadas de mandíbulas edêntulas foram analisadas na região do primeiro molar inferior. As mensurações desconsideraram a crista do rebordo residual até que se alcançasse uma espessura óssea mínima de 5,0mm, e, a partir desse ponto foi mensurada a distância existente até o teto superior do canal mandibular.Resultados: observou-se, em média, 11,625mm de tecido ósseo, variando de 8,0 a 16,2mm, entre o teto superior do canal mandibular e a porção do rebordo alveolar residual, com espessura mínima de 5,0mm para a instalação do implante.Conclusão: na maioria dos casos avaliados, existiu osso suficiente em altura e espessura para uma adequada instalação de implantes osseointegrados...

Determine, by means of computerized tomography, the bone availability for implantation in the edentate region of the lower first molar, regarding the localization of the mandibular canal.Methodology: thirty-two computerized tomographies of edentate jaws in the region of the lower first molar were evaluated. For the measurements, the crest of the residual alveolar process was discarded, until a width of 5.0mm was reached. From there, the distance until the roof of the mandibular canal was measured.Results: there was an average of 11.625mm of the bone tissue, ranging from 8.0 a 16.2mm between the roof of the mandibular canal and the residual alveolar process, with a minimum thickness of 5.0mm for the implant installation.Conclusion: in the majority of the cases there was enough bone in height and width for osseointegrated implants...

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A restauração de dentes anteriores perdidos é grande desafio para o cirurgião-dentista. Nesses casos, o tratamento preferido tem sido a confecção de próteses sobre implantes. A adequada instalação dos implantes depende da presença de tecidos moles e duros, e, caso eles não estejam presentes, implica a necessidade de cirurgias compensatórias, que prolongarão o tempo de tratamento. Quando não há possibilidade de instalar implantes, as próteses fixas têm sido outra opção, porém, a necessidade de preparar os dentes vizinhos, a presença de grandes áreas edêntulas, bem como pilares com coroa clínica curta podem inviabilizar essa alternativa de tratamento. Uma interessante abordagem restauradora para essa área é a utilização de uma prótese parcial removível com duplo eixo de inserção, pois, além de ser tratamento protético pouco invasivo, não inviabiliza a utilização de outras modalidades de tratamento no futuro, e seu desenho colabora para adequado resultado estético...

The replacement of missing anterior teeth is a great challenge to the dentist. In such cases, the treatment of choice today is implant-supported restorations. Proper placement of implant fixtures depends on the volume and height of soft and hard tissues. When they are not available, the need for compensatory surgery extends the treatment time. When implants are not feasible, fixed partial dentures are a choice, but the preparation of the adjacent teeth, the presence of large edentulous areas, and short clinical crowns may prevent this treatment option. Another interesting approach to restore the anterior region is the use of a removable partial denture with double insertion path. This approach is a less invasive prosthetic treatment, and presents advantages such as reversibility and proper design that allos for a esthetic result...

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Uma adequada seleção de cor em Odontologia é imprescindível para se alcançar um bom resultado estético. O método mais difundido para realizar tal seleção é o visual, no qual se realizam comparações simultâneas entre a cor do dente e a cor de uma escala. Dessa forma, o método de seleção visual da cor gera muitas dúvidas, que variam desde a técnica de seleção até a escala mais adequada para a equiparação da cor. O conhecimento dos aspectos inerentes à estrutura dentária, à fonte de luz, às escalas e até mesmo à pessoa que está observando a cor deve ser considerado durante a seleção. Além disso, todas essas informações devem ser corretamente transmitidas ao técnico de laboratório para que o resultado final seja o desejado. O presente artigo reúne as principais informações referentes aos dentes, fonte luminosa, observador e escalas disponíveis, assim como apresenta uma sugestão de mapa cromático para comunicação laboratorial.

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Na tentativa de substituir as infraestruturas metálicas das próteses dentárias, cerâmicas de alto desempenho têm sido aprimoradas e cada vez mais utilizadas na odontologia. Dentre as cerâmicas odontológicas, a zircônia tem surgido como material versátil e promissor, em função de suas propriedades biológicas, mecânicas e ópticas, o que certamente tem acelerado o uso rotineiro da tecnologia CAD/CAM em coroas unitárias, próteses fixas, pilares e próteses sobre implantes, por técnicos e cirurgiões-dentistas. Este artigo apresenta um relato de caso clínico em que uma cerâmica à base de zircônia foi associada à tecnologia CAD/CAM, considerando-se suas indicações e contra-indicações, em função da microestrutura e propriedades desse material

In an attempt to replace metal infrastructure of crowns and bridges, high-strength ceramics have been developed and are increasingly used. The zirconia has been introduced as a promising, versatile material because of its biological, mechanical, and optical properties. This definitely boosted the use of CAD / CAM technology by dentists and dental technicians. This article presents a case report where a zirconia based ceramic has been associated to a CAD / CAM system, and to present the indications and contraindications according to the features of the material

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