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Objective: This study aimed to evaluate the bond strength of a universal adhesive to dentin (µTBS) using different time periods of airborne particle abrasion (APA) and two types of acid etching. Methods: Seventy-two human third molars were divided into 9 groups (n=8) according to dentin pretreatment: APA duration (0, 5, or 10s) and acid etching (no acid - NA, 37% phosphoric acid - PhoA, or 1% phytic acid - PhyA). APA was performed at a 0.5 cm distance and air pressure of 60 psi using 50 µm aluminum oxide particles. Afterwards, two coats of Single Bond Universal adhesive (3M) were applied to the dentin surface. Composite blocks were built using the incremental technique, sectioned into 1×1 mm slices and subjected to microtensile bond strength (µTBS) testing. Fracture patterns and surface topography of each dentinal pretreatment were evaluated using a Scanning electron microscope (SEM). Bond strength data were analyzed using two-way ANOVA and Bonferroni post-hoc tests. Results: The group that received pretreatment with 5s APA and PhoA presented higher µTBS values among all groups, which was statistically different when compared with the PhoA, 10APA+PhoA, and 5APA+PhyA groups. PhyA did not significantly influence the bond strength of the air-abraded groups. Finally, adhesive failure was considered the predominant failure in all groups. Conclusion: Dentin pretreated by airborne particle abrasion using aluminum oxide demonstrated an increase in bond strength when abraded for 5 seconds and conditioned with phosphoric acid in a universal adhesive system.

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BACKGROUND: This study aimed to evaluate dentin wear and biological performance of desensitizing materials. METHODS: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05). RESULTS: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments. CONCLUSIONS: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.

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BACKGROUND: Tooth brushing is a universal recommendation. However, the recommendations related to the time of its execution are conflicting, especially when dealing with patients at risk of erosive tooth wear (ETW) or dental caries. SUMMARY: Our objective was to summarize the evidence on the timing of brushing with fluoridated toothpaste in relation to ETW and cariogenic dietary challenges. We conducted a scoping review following the PRISMA-ScR checklist, using three databases searching for in vivo, in situ, or in vitro studies involving human teeth exposed to either a cariogenic or an erosive challenge. Only models including human saliva and fluoride were assessed. Data selection, extraction, and risk of bias analysis were done in duplicate and independently. From 1,545 identified studies, 17 (16 related to ETW and 1 to dental caries) were included. Most evidence (n = 10) supported that brushing with a fluoride-containing product does not increase ETW, independent of the moment of brushing. Delaying tooth brushing up to 1 h (n = 4) or individualized recommendations based on the patient's problem (n = 2) were less frequent. Only one study reported that brushing pre- or post-meal does not affect Streptococcus mutans counts. Most data were in situ (n = 13), and the overall study quality was judged as sufficient/low risk of bias. KEY MESSAGES: Although the available evidence lacked robust clinical studies, tooth brushing using fluoridated products immediately after an erosive challenge does not increase the risk of ETW and can be recommended, which is in line with recommendations for dental caries prevention. Furthermore, we suggest updating the international guidelines to promote individualized recommendations based on risk factors to prevent either ETW or dental caries.

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OBJECTIVE: To determine the effect of airborne particle abrasion (APA) on micro-tensile bond strength (µTBS) to dentin using different air-abrasion/polishing powders. METHODS: The bonding effectiveness of G2 Bond Universal (G2B), used in etch-and-rinse (E&R) and self-etch mode (SE), was tested on bur-cut dentin and dentin air abraded/polished using six different powders (aluminum oxide 29 µm (AO29) and 53 µm (AO53), aluminum trihydroxide (AT), sodium bicarbonate (SB), sodium bicarbonate soft (SBsoft) and bioactive glass (BG); Velopex). Adhesive-composite resin specimens were immersed in distilled water at 37 °C for one week and cut into microspecimens. Half of the specimens were subjected to 50,000 thermocycles (aged). Immediate and aged µTBS to dentin were measured. Statistical analysis was performed using linear mixed-effects (LME) modeling (p < 0.05). RESULTS: Comparing the aged bond strengths to air-abraded/polished dentin with bur-cut dentin, pretreatment with SB and SBsoft in combination with G2B used in E&R mode, and BG air polishing in combination with both application modes (E&R, SE), resulted in a significantly higher bond strength. Dentin bond strength was only significantly lower when air abraded with AO29 and using G2B in SE mode. Aging did not significantly influence bond strength for both application modes (E&R, SE), except for AO29 and AT-treated dentin, where bond strengths decrea sed significantly using G2B in SE mode. In general, G2B reached significantly higher bond strengths on air-abraded/polished dentin in E&R mode than in SE mode. CONCLUSION: Air-abrasion/polishing did not impair dentin bond strength using G2B, except when dentin was air abraded with AO29 and using G2B in SE mode. Air polishing positively influenced the bond strength to dentin in specific groups. CLINICAL SIGNIFICANCE: APA is safe concerning bonding to dentin. The E&R application mode is preferred using G2B as adhesive on air-abraded/polished dentin. Air polishing with BG positively influenced dentin bond strength for both application methods.

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OBJECTIVES: To assess the effect of different tin-containing toothpastes on the control of erosive tooth wear in enamel and dentin. METHODS: Enamel and dentin slabs were randomly distributed into 7 experimental groups (n = 10/substrate): C-: negative control (Artificial saliva); AmF (regular fluoridated toothpaste without tin); Sn-1 (SnF2/NaF); Sn-2 (SnF2/NaF/SnCl2); Sn-3 (SnCl2/NaF); Sn-4 (SnF2/SnCl2); Sn-5 (SnCl2/AmF/NaF/chitosan). Specimens were submitted to 5-day erosion-abrasion cycling. Surface loss (SL) was determined with an optical profilometer. Tin deposition on the tooth surfaces and some characteristics of the toothpastes (pH, potentially available F-, %weight of solid particles, and RDA) were also assessed. Data were statistically analyzed (α = 0.05). RESULTS: For enamel, the Sn-2 presented the lowest SL, not differing significantly from AmF, C+, and Sn-3. The SL of these groups was significantly lower than the C-, except for Sn-3. Sn-1 and Sn-4 were also not significantly different from C-. For dentin, C- significantly showed the highest SL values, whilst, Sn-1 presented the lowest SL, not differing significantly from AmF, Sn-2, C+, and Sn-3. There was a significant positive association between enamel SL and the pH and tin deposition. Dentin SL was significantly negatively associated with the %weight of solid particles and RDA. CONCLUSIONS: Most of the tin-toothpastes were able to exhibit some protection against ETW. In this process, the toothpastes characteristics play a role, as lower enamel SL was significantly associated with lower pH values and tin deposition; and lower dentin SL was associated with higher %weight of solid particles and RDA of the toothpastes. CLINICAL SIGNIFICANCE: Tin-containing toothpastes can be used for erosive tooth wear protection, but our study showed that their effect depends on the pH, amount of tin deposition, % weight of solid particles and RDA of the toohpastes.

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Abstract Objectives This study aimed to assess the effect of proanthocyanidin, palm oil and vitamin E against erosive and erosive+abrasive challenges in vitro after enamel pellicle formation in situ. Methodology Bovine enamel blocks (n=84) were obtained and divided into the following treatment groups: negative control (NC) - deionized water; positive control (PC) - SnCl2/NaF/AmF-containing solution; palm oil (PO); 2% proanthocyanidin (P2); vitamin E (VitE); 2% proanthocyanidin+palm oil (P2PO); and 2% proanthocyanidin+vitamin E (P2VitE). For 5 days, one half of the sample from each group was subjected to erosion and the other half was subjected to erosion+abrasion. The acquired enamel pellicle (AEP) was pre-formed in situ for 30 minutes. The specimens were then treated in vitro with solutions (500 µl, 30s for each group). Subsequently, the blocks were left in the oral cavity for another hour to obtain the modified AEP. The blocks were immersed in 0.5% citric acid (pH=2.5) for 90s, 4×/day. AEP formation and treatment were carried out before the first and third erosive challenges, and after these challenges, abrasive cycles (15s) were performed on half of the samples. Enamel wear was quantified by profilometry and data were analyzed by two-way ANOVA and Tukey's test (p<0.05). Results All groups showed higher wear when exposed to erosion+abrasion than when exposed to erosion alone (p=0.0001). PO, P2VitE, P2, and P2PO showed enamel wear similar to the PC group, but only PC, PO and P2VitE differed from the NC group. The other groups behaved similarly to NC. Conclusion It was concluded that the combination of proanthocyanidin and vitamin E was effective in reducing wear in the face of in vitro erosive and erosive+abrasive challenges.

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Objective: The aim of this study was to determine if SEM used with imaging software could be used to quantitatively determine the extent of dentine roughness due to tooth-brushing. Material and methods: Flat, polished dentine surfaces were subjected to 25,000 cycles of simulated tooth-brushing at 2 strokes per second with a load of 200 g. At the end of the brushing cycle, dentine surfaces were first assessed using profilometry and then subjected to SEM analysis. Ra (average roughness) readings were obtained for profilometric assessment. Using imaging software, the horizontal distance between adjacent characteristic grooves noted on micrographs was measured, ensuring that the middle of each crest of the associated groove was used as the reference point, the Crest-to-Crest distance (C-C distance). These two parameters were examined statistically for correlation. Results: When Spearman Rank tests were utilized the correlation between average Ra and crest to crest measurements was 0.709 (p <0.01). The Bland Altman plot, however, showed poor agreement between the two test parameters. Conclusion: Further work is needed to validate the use of this methodology in the quantitative assessment of tooth surface loss due to abrasion (AU)

Objetivo: O objetivo deste estudo foi determinar se o MEV usado com software de imagem poderia ser usado para determinar quantitativamente a extensão da rugosidade da dentina devido à escovação dentária. Material e Métodos: Superfícies dentinárias planas e polidas foram submetidas a 25.000 ciclos de escovação dentária simulada a 2 movimentos por segundo com uma carga de 200g. No final do ciclo de escovação, as superfícies dentinárias foram primeiro avaliadas por perfilometria e depois submetidas à análise MEV. Leituras de Ra (rugosidade média) foram obtidas para avaliação perfilométrica. Utilizando um software de imagem, foi medida a distância horizontal entre sulcos característicos adjacentes observados nas micrografias, garantindo que o meio de cada crista do sulco associado fosse usado como ponto de referência, a distância crista a crista (distância CC). Esses dois parâmetros foram examinados estatisticamente para correlação. Resultados: Quando foram utilizados os testes de Spearman Rank, a correlação entre a média de Ra e as medidas de crista a crista foi de 0,709 (p<0,01). O gráfico de Bland Altman, no entanto, mostrou fraca concordância entre os dois parâmetros de teste. Conclusão: Mais trabalhos são necessários para validar o uso desta metodologia na avaliação quantitativa da perda da superfície dentária devido à abrasão(AU)

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El desgaste natural de los dientes ocurre dependiendo de factores como: calidad de la estructura dental, calidad de la saliva, biotipo facial que determina la fuerza de mordida; de acuerdo a estos factores locales bucales se va envejeciendo la dentadura. Pero los deportistas presentan un patrón de desgaste mayor y continuo debido al tipo de deporte que practican, las horas de entrenamiento, el consumo de bebidas con pH ácido, el cepillado dental vigoroso; todos estos factores pueden conducirlos a que desarrollen lesiones no cariosas (AU)

The natural wear of the teeth occurs depending on factors such as: quality of the dental structure, quality of the saliva, facial biotype that determines the bite force, according to these local oral factors, the teeth age. But in athletes they present a pattern of greater and continuous wear due to the type of sport they practice, the hours of training, the consumption of drinks with an acidic pH, vigorous tooth brushing; all these factors can lead them to develop non-carious lesions (AU)

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This study investigated the effect of commercially available whitening toothpastes containing charcoal on dentin. Nine charcoal-containing toothpastes were compared with 3 whitening toothpastes (positive control) and distilled water (negative control). Periodontally hopeless molars were cleaned and washed and the occlusal table removed to expose dentin. The teeth were mounted in auto-polymerizing resin and exposed dentine surfaces polished with water-cooled decreasing grits of silica carbide paper up to 1500 grit. Baseline average roughness (Ra) measurements were taken. Specimens were then mounted in an automatic tooth-brushing machine and brushed for 5000 cycles. Repeat Ra measurements were taken. Specimens were brushed in 5000-cycle increments up to 25,000 cycles with Ra measurements being taken at each time point. Between abrasive challenges specimens were stored in distilled water. All toothpaste samples were sputter coated and examined under a scanning electron microscope to qualify the shape and size of the abrasive components of the formulations. Data were analyzed using a two-way analysis of variance with post hoc Bonferroni. The results demonstrated that the abrasive effect, in terms of increasing Ra, on dentin was noted as early as 5000 cycles for all the tested toothpastes (p<0.05). The effect of continued brushing showed an overall cumulative effect on dentine roughness up to 25000 cycles. When toothpastes were compared between groups at each time-point, dentin specimens brushed with Pursito were statistically similar to the control group. At 25,000 cycles all dentin samples were significantly rougher compared to Pursito and the control groups. It may be concluded that all the tested toothpastes have an abrasive effect on dentin surfaces.

Este estudio investigó el efecto sobre la dentina de las pastas dentales blanqueadoras disponibles en el mercado que contienen carbón vegetal. Se compararon nueve dentífricos que contenían carbón vegetal con 3 dentífricos blanqueadores (control positivo) y agua destilada (control negativo). Los molares sin material periodontal se limpiaron y lavaron y se retiró la tabla oclusal para exponer la dentina. Los dientes se montaron en resina autopolimerizable y las superficies expuestas de la dentina se pulieron con papel de carburo de sílice de grano decreciente enfriado con agua hasta grano 1500. Se tomaron medidas de rugosidad promedio (Ra) de referencia. Luego, las muestras se montaron en una máquina automática de cepillado de dientes y se cepillaron durante 5000 ciclos. Se tomaron medidas repetidas de Ra. Las muestras se cepillaron en incrementos de 5000 ciclos hasta 25 000 ciclos y se tomaron medidas de Ra en cada punto de tiempo. Entre periodos abrasivos, las muestras se almacenaron en agua destilada. Todas las muestras de pasta de dientes se recubrieron por pulverización catódica y se examinaron bajo un microscopio electrónico de barrido para calificar la forma y el tamaño de los componentes abrasivos de las formulaciones. Los datos se analizaron utilizando un análisis de varianza de dos vías de Bonferroni post hoc. Los resultados demostraron que el efecto abrasivo, en términos de aumento de Ra, sobre la dentina se notó ya en 5000 ciclos para todas las pastas dentales probadas (p<0,05). El efecto del cepillado continuo mostró un efecto acumulativo general sobre la rugosidad de la dentina hasta 25.000 ciclos. Cuando se compararon las pastas dentales entre los grupos en cada momento, las muestras de dentina cepilladas con Pursito fueron estadísticamente similares al grupo de control. A los 25.000 ciclos, todas las muestras de dentina eran significativamente más ásperas en comparación con Pursito y los grupos controles. Se puede concluir que todas las pastas dentales probadas tienen un efecto abrasivo sobre las superficies dentinarias.

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PURPOSE: This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces. METHODS: Bovine enamel (n = 72) and dentin (n = 72) blocks were obtained and restored using RMGIC (n = 36) or CR (n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion-abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF2; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey's test (α = 0.05). RESULTS: Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF (p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste (p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive-abrasive conditions.

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AIM: To evaluate associations between oral hygiene and gingival abrasion (GA) in a rural population from southern Brazil. MATERIALS AND METHODS: A population-based sample representative of individuals from a rural community in southern Brazil was included. Individuals aged 15 years or older and who had five teeth or more present were selected for this analysis. GA extent was defined as the total number of abrasions per individual. An adjusted multilevel negative binomial regression analysis was used to investigate the associations between site-, tooth- and individual-level variables and GA. Mean ratios (MR) and 95% confidence intervals (95% CI) were calculated. RESULTS: Five hundred ninety-five dentate individuals aged 15-82 years were analysed. In the adjusted models, brushing more than twice a day (MR = 1.13; 95% CI 1.02-1.26) and brushing with a hard/medium-bristle toothbrush (MR = 1.11; 95% CI 1.01-1.23) were significantly associated with more generalized GA. CONCLUSIONS: The extent of GA was independently associated with greater brushing frequency and the use of a toothbrush with harder bristles in residents of a rural area.

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OBJECTIVES: To compare the effect of whitening toothpastes with different mechanisms of action on discolored teeth subjected to additional staining/or not. METHODS: One hundred twenty tooth specimens were stained for 14 days (staining broth under constant agitation and pH=7) and then allocated into the groups of toothpastes with different whitening ingredients (n=10): 1. Regular - Colgate Total 12 Clean Mint; 2. CLWI - Colgate Luminous White Instant (blue pigment); 3. CLWA - Colgate Luminous White Advanced Expert (hydrogen peroxide); 4. CLWAC - Colgate Luminous White Activated Charcoal (activated charcoal); 5. OB3D - Oral-B 3D WHITE Brilliant Fresh (abrasive); 6. TW - Teeth Whitening (charcoal powder). Specimens were submitted to two experimental models: A. Daily staining-toothbrush cycling: staining solution (5min), toothbrushing (45 strokes) and artificial saliva (3h), 2x/day, for 5 days; B. Only toothbrushing (30.000 brushing strokes). Color change was determined with a spectrophotometer (CIEDE2000 and Whiteness Index for Dentistry - WID) and statistically analyzed (α=0.05). RESULTS: For both models, ΔE00 and Δa did not differ significantly between the whitening toothpastes and the regular. All groups showed a decrease in tooth yellowness (-Δb) and an increase in WID. Group Teeth Whitening exhibited a decrease in luminosity (-ΔL). In model A, Groups did not differ significantly from the Regular in terms of ΔL (p=0.35) and Δb (p=0.74). Groups CLWI and OB3D exhibited a decrease in luminosity. Reduced redness (-Δa) occurred only in Group CLWI. In Model B, Groups OB3D (p=0.021) and CLWA (p=0.001) exhibited higher change in luminosity than in Group Teeth Whitening. All exhibited increased redness (+Δa) and lightness (+ΔL), except the Regular, CLWAC, and Teeth Whitening. Group OB3D had a significantly higher change in Δb than the Regular (p=0.021). CONCLUSIONS: Irrespective of the mechanism of action, all toothpastes reduced tooth yellowness and promoted similar overall color change. Exposure of the teeth to additional staining during the toothbrushing cycles did not influence the effect of the whitening toothpastes. CLINICAL SIGNIFICANCE: Whitening toothpastes should be tested in conditions that more closely simulate their use in a clinical scenario, in which alternate cycles of staining and brushing occur on a daily basis. However, even in such conditions, they were unable to promote a color change that differed from that of a regular toothpaste.

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Abstract This study aimed to investigate the failure behavior of 3 mol.% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) prosthetic crowns air-abraded with aluminum oxide (AO) particles of different sizes. Ninety ceramic premolar crowns were produced with 3Y-TZP frameworks veneered with porcelain. Crowns were randomly divided into three groups, according to the size of the air abrasion AO particles (n = 30): (GC) untreated (control); (G53) 53 µm; (G125) 125 µm. Air abrasion was performed with 0.25 mpa pressure, 10-mm distance, for 10 s. Crowns were adhesively cemented to dentin analog abutments. Specimens were loaded in compression to failure, in 37oC distilled water, using a universal testing machine (n = 30). Fractographic analysis was performed using a stereomicroscope and SEM. The roughness of the crown's inner surface was evaluated using an optical profilometer (n = 10). Fracture load data were statistically analyzed with Weibull analysis and roughness data with Kruskal-Wallis (α = 0.05). GC had the lowest characteristic fracture load (L0), while G53 and G125 had higher and statistically similar L0 values. The Weibull modulus (m) was similar among groups. The failure modes observed were catastrophic failure and porcelain chipping. There were no differences between the roughness parameters for the experimental groups (p > 0.05). The size of the AO particles did not affect the fracture load and failure mode of 3Y-TZP crowns. Air abrasion with 53 µm and 125 µm particles resulted in a higher fracture load of ceramic crowns than the untreated group while maintaining their reliability and surface characteristics.

Resumo O objetivo deste estudo foi investigar o efeito do jateamento com óxido de alumínio (AO) com diferentes tamanhos de partículas no comportamento de fratura de coroas protéticas de zircônia tetragonal estabilizada com 3 mol% de ítria (3Y-TZP). Noventa coroas cerâmicas de pré-molares foram produzidas com infraestruturas de 3Y-TZP recobertas com porcelana. As coroas foram divididas aleatoriamente em três grupos, de acordo com o tamanho das partículas de AO do jateamento (n = 30): (GC) não tratada (controle); (G53) 53 µm; (G125) 125 µm. O jateamento foi realizado com pressão de 0,25 MPa, distância de 10 mm, por 10 s. As coroas foram cimentadas adesivamente em pilares análogos à dentina. As coroas foram testadas em compressão até a falha, em água destilada a 37ºC, usando uma máquina universal de ensaios (n = 30). A análise fractográfica foi realizada usando estereomicroscópio e MEV. A rugosidade da superfície interna das coroas foi avaliada usando um perfilômetro óptico (n = 10). Os dados de carga de fratura foram analisados ​​estatisticamente com análise de Weibull e os dados de rugosidade com Kruskal-Wallis (( = 0,05). GC apresentou a menor carga característica de fratura (L0), enquanto G53 e G125 apresentaram valores de L0 maiores e estatisticamente semelhantes. O módulo de Weibull (m) foi semelhante entre os grupos. Os modos de falha observados foram falha catastrófica e lascamento da porcelana. Não houve diferenças entre os parâmetros de rugosidade para os grupos experimentais (p > 0,05). O tamanho das partículas de AO não afetou a carga de fratura e o modo de falha das coroas 3Y-TZP. O jateamento com partículas de 53 µm e 125 µm resultou em maior carga de fratura das coroas cerâmicas do que o grupo não tratado, mantendo sua confiabilidade e características de superfície.

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BACKGROUND: This study aimed to compare a connective tissue graft (CTG) to a (porcine) xenogeneic acellular dermal matrix (XDM), both associated with modified coronally advanced flap (MCAF) and partial resin composite restoration to treat multiple combined defects (CDs). METHODS: Seventy-eight defects in 38 patients presenting multiple combined defects, that is, gingival recession associated with non-carious cervical lesions, were treated by partial resin composite restoration (apical margin up to 1 mm of the estimated cement-enamel junction) and MCAF along with CTG or XDM. After 6 months, the groups were compared with regard to clinical, patient-centered, and esthetic outcomes. RESULTS: CD coverage was 72.9% for CTG versus 50.7% for XDM (P < 0.001). Recession reduction was 2.3 mm for CTG versus 1.5 mm for XDM (P < 0.001). CTG resulted in a greater increase in keratinized tissue width (CTG: 0.96 mm vs. XDM: 0.3 mm, P = 0.04) and gingival thickness (CTG: 0.9 mm vs. XDM: 0.3 mm, P < 0.001). Both treatments successfully reduced dentin hypersensitivity and increased esthetics satisfaction, with no statistically significant intergroup differences. Moreover, XDM patients experienced a shorter surgery duration (CTG: 57.2 min vs. XDM: 37.4 min, P < 0.001) and less time to no pain (visual analog scale  =  0; CTG: 6.5 days vs. XDM: 3.5 days, P = 0.04). CONCLUSION: CTG resulted in significantly greater root coverage and increased keratinized tissue width compared to XDM for treating multiple partially restored CDs. However, increased root coverage at the CTG sites was accounted for by increased probing depth compared to the XDM sites.

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OBJECTIVES: This systematic review investigated the prevalence of tooth wear between patients with and without Down syndrome. METHODS: Six databases (Embase, LILACS, Livivo, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey and ProQuest) were searched until March 7, 2022. Observational studies were included to assess the differences in tooth wear prevalence and/or severity in Down syndrome and non-syndromic controls. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations were followed. Three reviewers independently screened studies, extracted data, assessed the methodological quality (Joanna Briggs Institute) and graded the certainty of evidence through the Grading of Recommendations, Assessment, Development, Evaluation (GRADE) approach. Results were summarized through meta-analyses using a random-effects model. The protocol was registered at PROSPERO (CRD42021266997). RESULTS: Of the 1382 records identified, six cross-sectional studies were included. Individuals with Down syndrome had a higher prevalence and were more likely to have tooth wear than individuals without Down syndrome (44% × 15%; OR = 4.43; 95% CI 3.17-6.18; p < 0.00001; I2 = 8%). Also, the severity of tooth wear was higher in the Down syndrome group (n = 275) compared with the controls (n = 294). The certainty of evidence analysis was very low. CONCLUSIONS: Based on very low certainty of the evidence, patients with Down syndrome had a higher prevalence and likelihood and severity of tooth wear when compared to those without Down syndrome. CLINICAL RELEVANCE: Screening early tooth wear lesions should be carefully done in the Down syndrome population since its occurrence is remarkable compared to the general population.

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INTRODUCTION: Gingival recession (GR) is a relevant clinical condition due to its high prevalence worldwide, which leads to aesthetic demands and dentin hypersensitivity. Collagen matrices have been associated with different designs of coronally advanced flaps (CAFs) to treat GR defects. However, the literature lacks long-term follow-up of this treatment option. The aim of this study is to present the long-term follow-up (up to 7 years) of two GR defects (associated or not with noncarious cervical lesion) treated with a CAF and a collagen matrix (CM). CASE PRESENTATION: Case 1 underwent a CAF associated with a CM to treat a single GR defect. After 7 years, Case 1 presented with 3 mm of recession reduction, which corresponds with the 85.7% of root coverage. Case 2 presented two GR defects associated with noncarious cervical lesions (NCCLs). The NCCLs were partially restored with resin composite and then underwent a modified CAF for multiple defects and a CM. After 5 years of follow-up, Case 2 presented with 1.5 and 2.5 mm of recession reduction, which corresponds with the average 83.3% defect coverage. CONCLUSION: These two cases may show that CMs can provide long-term stable outcomes in the treatment of GR defects. Why is this case new information? One of the cases is the first one to describe a 7 years of follow-up after CAF+CM to treat gingival recession defects. What are the keys to successful management of this case? Correct material handling. Adequate restorative protocol and surgical technique. What are the primary limitations to success in this case? Diagnose Patient compliance.

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Objective: to evaluate the effect of novel zirconia surface treatment method on shear bond strength between zirconia and veneering porcelain compared to air abrasion and CoJet surface treatment methods. Material and Methods: twenty-one zirconia ceramic discs were fabricated with diameter of 7mm and 3mm thickness and divided according to surface treatment into three subgroups, control group I: Air Abrasion (n=7), group II: CoJet (n=7) and group III: Z-etch (n=7). Porcelain was built over the zirconia specimens with a customized mold and fired in a ceramic furnace. All specimens were thermocycled (20000 cycles) between 5°C ­ 55 °C with a dwell time of 30 seconds in distilled water and shear bond strength of veneering porcelain to each zirconia specimen was tested using a universal testing machine. Results: numerical data were explored for normality by checking the distribution of data and using tests of normality (Kolmogorov-Smirnov and Shapiro-Wilk tests). One-way ANOVA test was used to compare between the groups. There was a statistically significant difference between the three groups (P-value = 0.002, Effect size = 0.503). Pair-wise comparisons between groups revealed that Z-etch showed the statistically significantly highest mean shear bond strength. Conclusion: zirconia coating using z-etch is showing promising results in promoting higher bond strength than conventional surface treatment methods as air abrasion and silica coating (AU)

Objetivo: avaliar o efeito do novo método de tratamento de superfície de zircônia na resistência ao cisalhamento entre a zircônia e a porcelana de cobertura em comparação com os métodos de abrasão a ar e jateamento com CoJet. Material e Métodos: vinte e um discos de zircônia foram confeccionados com diâmetro de 7mm e espessura de 3mm e divididos de acordo com o tratamento de superfície em três subgrupos, grupo controle I: Abrasão a ar (n=7), grupo II: CoJet (n=7) e grupo III: Z-etch (n=7). A porcelana foi aplicada sobre os espécimes de zircônia com um molde personalizado e sinterizada em forno de cerâmica. Todos os espécimes foram termociclados (20.000 ciclos) entre 5°C - 55°C com um tempo de permanência de 30 segundos em água destilada e a resistência ao cisalhamento da porcelana de cobertura foi testada através de uma máquina de ensaio universal. Resultados: os dados numéricos foram avaliados quanto à normalidade, verificando a distribuição dos dados e utilizando testes de normalidade (testes de Kolmogorov-Smirnov e Shapiro-Wilk). O teste ANOVA de um fator foi utilizado para comparar os grupos. Houve uma diferença estatisticamente significativa entre os três grupos (P-valor = 0,002, tamanho do efeito = 0,503). As comparações pareadas entre os grupos revelaram que o Z-etch apresentou a resistência de união ao cisalhamento estatisticamente significativamente mais alta. Conclusão: o revestimento de zircônia utilizando Z-etch mostrou resultados promissores para o aumento da resistência de união em comparação aos métodos convencionais de tratamento de superfície, como abrasão a ar e revestimento de sílica (AU)

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Abstract Dental hard tissue conditions can be of pre- or post-eruptive nature, such as enamel fluorosis and erosive tooth wear (ETW), respectively. Dental enamel fluorosis is caused by the chronic and excessive intake of fluoride during enamel development, leading to increased fluoride concentration and increased porosity. ETW has become a common clinical condition and often impairs dental function and aesthetics. This in vitro study tested the hypothesis that fluorotic enamel presents different susceptibility to dental erosion-abrasion. It consisted of a 3×3×2 factorial design, considering a) fluorosis severity: sound (TF0), mild (TF1-2), moderate (TF3-4); b) abrasive challenge: low, medium, and high; and c) erosive challenge: yes or no. A total of 144 human teeth were selected according to the three fluorosis severity levels (n=48), and subdivided into six groups (n = 8) generated by the association of the different erosive and abrasive challenges. Enamel blocks (4×4 mm) were prepared from each tooth and their natural enamel surfaces subjected to an erosion-abrasion cycling model. After cycling, the depth of the lesions in enamel was assessed by profilometry. ANOVA showed that the three-way and two-way interactions among the factors were not significant (p > 0.20). Enamel fluorosis level (p=0.638) and abrasion level (p = 0.390) had no significant effect on lesion depth. Acid exposure caused significantly more enamel surface loss than water (p < 0.001). Considering the limitations of this in vitro study, fluorosis did not affect the susceptibility of enamel to dental erosion-abrasion.

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O objetivo deste estudo foi avaliar o efeito de produtos contendo carvão ativado na alteração de cor do dente, na rugosidade superficial e no brilho do esmalte, considerando seu modo de ação químico (sem abrasão) e químico-mecânico (com abrasão). A perda de superfície do esmalte após a escovação também foi avaliada. Espécimes em dente bovino polido foram divididos em grupos de acordo com o tratamento e o modo de ação (n=15/grupo). Os produtos utilizados foram: água deionizada (Controle negativo - CN); Colgate® Máxima Proteção Anticáries (Dentifrício convencional ­ controle positivo - CP); Colgate® Luminous White Carvão Ativado (LW); Oral-B® 3D White Therapy Charcoal (3DW); Curaprox® Black is White (BW); Dermavita® Whitemax (Pó de carvão ativado - WP). Foi realizada uma ciclagem de manchamento (imersão em clorexidina ­ 2 min, caldo de manchamento - 30 min, saliva artificial - 30 min) e tratamento (imersão nas suspensões - 2 min), repetida 28 vezes, simulando quatro semanas de tratamento (exposição aos tratamentos 2x/dia). Nos grupos de desafio químico/mecânico, foi realizada abrasão em máquina de escovação (15s ­ 200g) associada à exposição às suspensões com os produtos. A cor (L*a*b*), a rugosidade superficial (Ra) e o brilho (UB) foram mensurados por espectrofotômetro de reflectância, perfilômetro de contato e medidor de brilho, respectivamente. Adicionalmente, o potencial abrasivo dos produtos foi avaliado por meio da mensuração do desgaste do esmalte. Espécimes adicionais foram submetidos a 100.000 ciclos de abrasão para determinação da perda de superfície do esmalte (µm), por meio do cálculo da variação da diagonal maior da indentação Knoop produzida na superfície do esmalte por um microdurômetro. A alteração de cor (ΔEab e ΔE00) e o índice de brancura (WID) foram calculados. Os dados de cor, rugosidade e brilho foram submetidos aos testes ANOVA dois fatores e Tukey (5%). Os grupos submetidos ao desafio químicomecânico resultaram em menor alteração de cor e menor variação do WID após a ciclagem de manchamento/tratamento comparados aos que não foram submetidos à abrasão (p=0,0001), resultando em maior potencial de prevenção/remoção do manchamento. Os dentifrícios e o pó de carvão apresentaram resultados similares para ambos os desafios, diferindo apenas do controle negativo. Para a rugosidade e o brilho, não houve diferença significante entre os grupos de desafio químico (p>0.05). Para químico-mecânico, WP apresentou maior rugosidade e menor brilho (p<0.05). Os dados de desgaste foram submetidos aos testes ANOVA um fator e Tukey (5%). O grupo tratado com WP apresentou os maiores valores de desgaste (p=0,0001). Os dentifrícios contendo carvão ativado apresentaram valores intermediários e os menores valores foram detectados nos grupos controle (CN e CP). Concluiu-se que os produtos contendo carvão ativado apresentaram potencial de prevenção/remoção do manchamento dental similar ao dentifrício convencional. Alterações significantes de rugosidade superficial e brilho foram detectadas com o uso do pó de carvão ativado. Os produtos contendo carvão ativado promoveram maior desgaste do esmalte (AU)

The aim of this study was to evaluate the effect of products containing activated charcoal on tooth color change, surface roughness, and enamel gloss, considering their chemical (without abrasion) and chemical-mechanical (with abrasion) mode of action. The enamel surface loss after brushing was also evaluated. Polished bovine tooth specimens were divided into groups according to treatment and mode of action (n=15/group). The products used were: deionized water (negative control - NC); Colgate® Maxima Proteção Anticáries (conventional toothpaste - positive control - CP); Colgate® Luminous White Activated Charcoal (LW); Oral-B® 3D White Therapy Charcoal (3DW); Curaprox® Black is White (BW); Dermavita® Whitemax (Activated charcoal powder - WP). Stain cycling (chlorhexidine immersion - 2 min, staining broth - 30 min, artificial saliva - 30 min) and treatment (immersion in the suspensions - 2 min) were performed, repeated 28 times, simulating four weeks of treatment (exposure to the treatments 2x/day). In the chemical/mechanical challenge groups, abrasion was performed in a brushing machine (15s - 200g) associated with exposure to the suspensions with the products. The color (L*a*b*), surface roughness (Ra), and gloss (UB) were measured by reflectance spectrophotometer, contact profilometer, and gloss meter, respectively. Additionally, the abrasive potential of the products was evaluated by measuring enamel wear. Additional specimens were subjected to 100,000 abrasion cycles to determine enamel surface loss (µm) by calculating the variation of the major diagonal of the Knoop indentation produced on the enamel surface by a microdurometer. The color change (ΔEab and ΔE00) and the whiteness index (WID) were calculated. The color, roughness, and gloss data were subjected to two-way ANOVA and Tukey (5%) tests. Groups subjected to chemical-mechanical challenge resulted in less color change and less WID variation after staining/treatment cycling compared to those not subjected to abrasion (p=0.0001), resulting in greater stain prevention/removal potential. Toothpastes and charcoal powder showed similar results for both challenges, differing only from the negative control. For roughness and gloss, there was no significant difference between the chemical challenge groups (p>0.05). For chemicalmechanical, WP showed higher roughness and lower gloss (p<0.05). Wear data were subjected to one-way ANOVA and Tukey (5%) tests. The WP treated group showed the highest values of wear (p=0.0001). The toothpastes containing activated charcoal showed intermediate values and the lowest values were detected in the control groups (CN and CP). It was concluded that the products containing activated charcoal had similar prevention/removal potential of dental staining as conventional toothpaste. Significant changes in surface roughness and gloss were detected with the use of activated charcoal powder. Products containing activated charcoal promoted more enamel wear. (AU)

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Poliéter-éter-cetona (Polyetheretherketone - PEEK) é um polímero de excelentes propriedades mecânicas, o que o torna um potencial candidato para substituir ligas metálicas em diversas especialidades odontológicas. Quando utilizado como infraestrutura para confecção de próteses odontológicas, a adesão do PEEK ao material de revestimento estético é determinante para a longevidade do tratamento, embora a baixa energia de superfície e grande estabilidade química do polímero tornem essa adesão um desafio a ser superado. Objetivo: Responder à pergunta: "Outros tratamentos de superfície do PEEK geram resistências de união superiores ao adesivo comercial?" Métodos: A busca foi feita nas bases Pubmed, , LILACS, Scopus, Web of Science, EMBASE, ProQuest e Google Scholar em junho de 2023 e não houve restrição relativa ao idioma ou à data de publicação dos estudos. Foram utilizados os seguintes termos e operadores booleanos: "polyether ether ketone" [MH] OR "polyether ether ketone" OR "polyetheretherketone" OR "polyetherketoneketone" OR "PEEK" AND "shear strength" [MH] OR "shear strength" OR "shear bond strength" OR "tensile bond strength" OR "shear" OR "tensile" OR "microtensile" OR "microshear" OR "bonding" OR "bond strength" OR "microtensile strength" OR "microshear bond strength" OR "bond" OR "adhesion" OR "bond integrity" OR "bonded" OR "Bonding Strength" OR "Bonding Behavior" OR "Adhesive Performance" OR " surface bonding" OR "tensile strength" [MH] OR "tensile strength". Foram incluídos exclusivamente estudos in vitro. Resinas compostas e resinas acrílicas foram consideradas como materiais de revestimento para PEEK. A média e o desvio padrão expressos em MPa e obtidos a partir de testes de cisalhamento e tração foram utilizados para relatar a resistência de união entre o PEEK e os materiais de revestimento. As meta-análises foram realizadas e a ferramenta Cochrane Collaboration avaliou o risco de viés (RoBDEMAT). Resultados: Foram selecionados 23 estudos. A resistência de união entre PEEK e resina composta foi favorecida pelo uso do adesivo (P<0,00001), independentemente do tipo de adesivo. O pré-tratamento com jato de areia Al2O3 (P<0,00001), ácido sulfúrico (P<0,00001), plasma frio (P=0,0006) e laser (P<0,00001) mostrou-se eficiente, embora o condicionamento com solução piranha não tenha tido efeito estatisticamente significativo (P=0,47). Conclusão: A aplicação de ácido sulfúrico antes do adesivo apresentou melhores resultados de resistência de união em comparação ao uso isolado do adesivo.

Polyether-ether-ketone (Polyetheretherketone - PEEK) is a polymer with excellent mechanical properties, which makes it a potential candidate to replace metallic alloys in several dental specialties. When used as an infrastructure for the manufacture of dental prostheses, the adhesion of PEEK to the aesthetic coating material is decisive for the longevity of the treatment, although the low surface energy and great chemical stability of the polymer make this adhesion a challenge to be overcome. Objective: Answer the question: "Do other PEEK surface treatments generate bond strengths superior to commercial adhesive?" Methods: The search was carried out in the Pubmed, LILACS, Scopus, Web of Science, and EMBASE, ProQuest and Google Scholar databases in June 2023 and there were no restrictions regarding the language or publication date of the studies. The following terms and bolean operators were used: "polyether ether ketone" [MH] OR "polyether ether ketone" OR "polyetheretherketone" OR "polyetherketoneketone" OR "PEEK" AND "shear strength" [MH] OR "shear strength" OR " shear bond strength" OR "tensile bond strength" OR "shear" OR "tensile" OR "microtensile" OR "microshear" OR "bonding" OR "bond strength" OR "microtensile strength" OR "microshear bond strength" OR "bond" OR "adhesion" OR "bond integrity" OR "bonded" OR "Bonding Strength" OR "Bonding Behavior" OR "Adhesive Performance" OR "surface bonding" OR "tensile strength" [MH] OR "tensile strength". Only in vitro studies were included. Composite resins and acrylic resins were considered as coating materials for PEEK. The mean and standard deviation expressed in MPa and obtained from shear and tensile tests were used to report the bond strength between PEEK and coating materials. Meta-analyses were performed and the Cochrane Collaboration tool assessed the risk of bias (RoBDEMAT). Results: 23 studies were selected. The bond strength between PEEK and composite resin was favored by the use of the adhesive (P<0,00001), regardless of the type of adhesive. Pretreatment with Al2O3 sandblasting (P<0,00001), sulfuric acid (P<0,00001), cold plasma (P=0,0006) and laser (P<0,00001) proved to be efficient, although conditioning with piranha solution did not have a statistically significant effect (P=0,47). Conclusion: The application of sulfuric acid before the adhesive showed better results in bond strength compared to the use of the adhesive alone.

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