RETRIEVING BROKEN INSTRUMENT IN HALF OF THE APIKAL ON CANINES TEETH WITH H-FILE BRAIDING TECHNIQUE

ABSTRACTBackground: Broken instruments affect the outcome and prognosis. A broken instrument will prevent the procedure of cleaning and shaping, irrigation and obturation of the root canal on the obstructed root section causing failure in endodontic treatment. There are some treatments for broken instrument including retrieving a broken fragment file and bypassing it on the root canal. the aim of the case report aims to provide an alternative for retrieving broken instruments using the H-file braiding technique. Method: A 38-year-old female patient came to the Dental Conservation Clinic RSGM Prof. Soedomo FKG UGM. A patient got a history of initial root canal treatment in a clinic, which ended with a separated file on canine teeth left upper. No complain pain, from the investigation radiographic there is an instrument broken in half apical. The teeth 23 seen temporary restoration cavity class I is still in good. Retrieving broken instruments using the H-file braiding technique, preparation with step back techniques, obturation with warm vertical condensation technique and class I composite resin restorations with fiber-reinforced retention. Result: No complain pain after 2 weeks retrieving broken instrument.Conclusion: The technique of the H-file braiding technique is one technique to retrieve a broken instrument, this procedure is simple, cost-effective, harmless to the teeth and gives root canal sealing.

Comparison of Self-Etching Adhesives and Etch-and-Rinse Adhesives on the Failure Rate of Posterior Composite Resin Restorations: A Systematic Review and Meta-Analysis

The aim of this study was to perform a systematic review with meta-analysis on the comparison of self-etching adhesives and etch-and-rinse adhesives with respect to the failure rate of posterior composite resin restorations. The study protocol was registered in PROSPERO (CRD42017078015), following PRISMA recommendations and PICO search strategy. Literature search was performed in the following databases: MEDLINE, ISI Web of Science, LILACS, SCOPUS, and Cochrane Library through July 2021. Six studies from five randomized clinical trials were included in the qualitative synthesis. The funnel plot detected important bias (all studies out of the funnel area). The meta-analysis showed a positive summary Cohen H effect size of 0.406 (95% CI: 0.100; 0.713, p = 0.009), favoring etch-and-rinse adhesives. The total number of failures (including restorations that required replacement and those that did not require replacement) were attributed to either marginal adaptation (five studies) or marginal staining (one study). A very low certainty of the evidence was obtained through GRADE analysis. In conclusion, current available evidence indicates that etch-and rinse adhesives performed better (with a low effect size) than self-etching adhesives in terms of failure rates in posterior composite restorations.

A Long-Term Follow-Up of Dental and Craniofacial Disturbances after Cancer Therapy in a Pediatric Rhabdomyosarcoma Patient: Case Report

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents. A boy aged seven years and five months was diagnosed with stage three group III embryonal parameningeal RMS with intracranial extension. He received chemotherapy for 23 weeks in combination with localized radiotherapy during the inductive phase of nine weeks (a total tumor dose of 5040 cGy). Three months later, he was referred to the department of pediatric dentistry for radiation-induced caries, the treatment of which was later terminated because of severe trismus and radiation-induced oropharyngeal mucositis. Three years later, the patient returned for the fitting of a prosthesis because of mastication problems. The dental treatments performed included: extraction, banding, composite resin restorations, root canal fillings, and stainless steel crown fabrication. An interim denture was fitted due to the poor retention of the fixed prosthesis. As the patient grew older, they developed facial asymmetry as a result of the prominent atrophy of their right cheek. By the age of 32, they had lost multiple teeth and exhibited severe facial deformity. Therefore, it is essential not only to involve a multidisciplinary medical team before, during, and after cancer therapy, but also to initiate long-term follow-ups given the potential effects of late sequelae after chemoradiation in multiple developmental areas.

Biomechanical Assessment of the Influence of Inlay/Onlay Design and Material on Stress Distribution in Nonvital Molars

Objectives The aim of this study was to evaluate the influence of inlays/onlays with or without pulp extension from different materials on stress distribution in endodontically treated molars by three-dimensional finite element analysis (3D FEA). Materials and Methods We used 3D mandibular molar models in this study. The models represented mesio-occluso-distal (MOD) cavities restored by inlays, onlays that covered buccal cusps, and onlays that covered all cusps with pulp extension (modified inlay/onlay) or without pulp extension (conventional inlay/onlay). Three materials (L: lithium disilicate glass-ceramic, P: polymer-infiltrated ceramic network [PICN], and C: nanofilled composite resin) were utilized. A force of 600 N was applied vertically and obliquely. Stress distribution in FEA models was analyzed using the von Mises theory. Results The results revealed that an oblique load generated higher stresses than vertical load. Composite resin restorations transmitted almost all the stress to the neighboring tooth structures, while lithium disilicate ceramic restorations absorbed most of the stresses. Moreover, modified inlays and onlays with pulp extension proved better than conventional inlays/onlays in terms of stress redistribution in dental structures. Onlays showed a better pattern of stress distribution than inlays within the restoration and the restored tooth. Conclusions According to stress distribution in dental structures, modified lithium disilicate ceramic onlays with pulp extension have been found to be the best choice to restore endodontically treated molars among the studied restorations.

Proximal contact tightness for Class II direct composite resin restorations: a literature review

This article reviews the literature regarding factors that affect proximal contact tightness (PCT) when restoring Class II cavities with direct composite resin. The PCT between two adjacent teeth is an important factor in maintaining oral health by ensuring that tooth positions remain stable, food is deflected away during mastication, dental papillae are maintained and to facilitate hygienic cleaning. If open contacts are created, there is a greater chance that the patient will experience periodontal problems or caries. Using sectional matrix systems with separation rings, and using materials with less polymerization shrinkage are effective methods to increase PCT and create significantly tighter contacts compared with using circumferential matrix systems. CPD/Clinical Relevance: Understating the clinical factors that affect proximal contact tightness between adjacent teeth is important to achieve optimal contacts in direct composite resin restorations to maintain oral health.

THE EFFECT OF DIFFERENT LIGHT CURED UNIT INTENSITIES ON THE DEPTH OF POLYMERIZATION OF BULK FILL SCULPTABLE COMPOSITE RESIN RESTORATIONS

Background : The latest development of dental material restoration is a bulk fill sculptable composite resin. This material can be applied to a 4 mm cavity at once irradiation. The success of polymerization can be affected by improper irradiation. Both the physical and mechanical properties of the material also can be decreased by improper irradiation. This study aimed to determine the effect of different light-cured unit intensities on the depth of polymerization of bulk fills sculptable composite resin restorations.Method : This research method was an experimental analytic type of post-test only control group design laboratory, consisting of 24 bulk fill sculptable composite resin with a diameter of 4mm x 6mm thickness divided into 6 groups:A1(3M ESPE-low intensity),A2(3M ESPE-high intensity),A3(3M ESPE-soft start intensity),B1(Ivoclar vivacity-low intensity),B2(Ivoclar vivadent-high intensity) and B3(Ivoclar vivadent-soft start intensity). Result : The results showed a significant effect of the low, high, and soft start intensity light-cured units in the bulk fill sculptable composite resin groups by Kruskal-Wallis test 0.00 (p <0.05).Conclusion : The best polymerization depth of bulk fill sculptable composite resin was 3M ESPE and it was affected by the high and low-intensity light-cured units

MICROABRASÃO DO ESMALTE

Enamel defects are described as changes in its structure characterized by local decrease or loss of its translucency from fluorosis, hypocalcifications, hypoplasias and inactive carious lesions with superficial and medium depth. The microabrasion of enamel selectively promotes the removal of its surface layer that presents color or structure modification through a mixture of abrasive and erosive agents mechanically. The association of these agents exposes a sub-layer of enamel with normal characteristics. This procedure can be used alone or associated with one or more aesthetic treatments, such as tooth whitening and composite resin restorations. Objective: to approach the microabrasion technique applied in dental enamel with changes in color and structure. Methodology: a non-systematic review of the scientific literature, published from 2009 to 2019, was carried out in the Virtual Health Library and in the academic Google. The inclusion criteria were articles in Portuguese and English, published in the last 10 years, that addressed the proposed theme. Conclusion: Dental microabrasion is a good alternative for aesthetic treatment for changes in the superficial structure of dental enamel, fluorosis and hypoplasia, because it wears little dental structure, restores aesthetics, does not cause damage to the pulp or periodontal tissues, requires little treatment time, does not require cavitary preparation, nor restorative material and is low cost. Aesthetic dissatisfaction is a concern of patients of all ages and the diagnosis of dental fluorosis should be the result of careful anamnesis and it should be taken into account that the etiology may be of various origins.

Influence of Finishing/Polishing in Surface Roughness of Conventional Nanocomposites and Bulk-Fill

The choice of the best finishing/polishing methods for composite resin restorations is critical to the choice of excellence results related to longer clinical longevity. The objective of the study was to evaluate the influence of finishing and polishing systems on the surface roughness of a Nanoparticulate and Bulk-fill resin. For the research, 40 sample disks were prepared for each composite: single-increment (BF) (Bulk Fill 3M), both 2 mm thick and 10 mm in diameter (FZ) (Filtek Z350, 3M). The specimens were randomly divided into 4 groups with 10 samples each, according to the different materials to which they were subjected to the finishing and polishing protocols: control [C]- diamond tip (FG 4137F, FAVA); [EN] polishing discs (Enhance, Dentsply); [SL] Abrasive discs (Sof-Lex Pop-on, 3M) and [PD] felt disc + Polishing paste (Diamond Excel, FGM). A surface roughness (Ra) was verified with a roughness meter in three different data volumes and calculated as arithmetic means. Data were statistically treated by one way ANOVA followed by test t and student t test. Regardless of the data tested, evidence of the systemic controlling against different systems for polishing control with control (p <0.05). PD presented statistically greater roughness to the EN and SL (p <0.001), these in turn obtained similar performance and presented the lowest values of roughness for both composites (p> 0.05). The different finishing / polishing methods influenced the surface roughness of both composites, observing for Sof-lex and Enhance lower Ra values.Keywords: Nanoparticles. Dental Polishing. Composite Resins.ResumoA escolha dos adequados métodos de acabamento/polimento para restaurações de resina composta é fundamental para obtenção de resultados de excelência, relacionados a maior longevidade clínica. O objetivo desse estudo foi avaliar a influência dos sistemas de acabamento e polimento na rugosidade de superfície das resinas nanoparticuladas convencional e bulk-fill. Para a pesquisa foram confeccionados 40 discos de amostra para cada compósito: Convencional [FZ] (Filtek Z350, 3M) e de incremento único [BF] (Filtek Bulk Fill, 3M), ambas com 2 mm de espessura e 10 mm de diâmetro. Foram divididos aleatoriamente em 4 grupos com 10 amostras cada, de acordo com os diferentes protocolos que receberam, sendo: controle (C) ponta diamantada (FG 4137F, FAVA); (EN) discos de silicone (Enhance, Dentsply); (SL) discos abrasivos (Sof-Lex Pop-on, 3M); (PD) Feltro + Pasta diamantada (Diamond Excel, FGM). A rugosidade de superfície (Ra) foi verificada com um rugosímetro em três leituras de diferentes direções e calculadas as médias aritméticas. Os dados foram tratados estatisticamente pelos testes ANOVA 1 fator seguido pelo teste t e t de student (p<0,05). Independente da resina testada, evidenciou-se diminuição da rugosidade pelos diferentes sistemas de polimento frente ao grupo controle (p<0,05). PD apresentou rugosidade estatisticamente maior à EN e SL (p<0,001), estes últimos que por sua vez obtiveram desempenho semelhante e apresentaram os menores valores de rugosidade para ambos os compósitos (p>0,05). Os diferentes métodos de acabamento/polimento influenciaram na rugosidade de superfície dos dois compósitos testados, observando para Sof-lex e Enhance menores valores de Ra. Palavras-chave: Nanopartículas. Polimento Dentário. Resinas Compostas.

Parafunctional habits and their relationship with fractures of composite resin restorations

Parafunctional habits are characterized by the repetition of acts that are not related to the normal functions of the stomatognathic system. This research aims to verify the parafunctional habits practiced, perceived and reported by patients and to verify the relationship with the fractures of direct composite resin restorations. Information from 205 patients, seen at the University Dental Clinic of the State University of Londrina, was collected. After data collection, a survey and synthesis of reported parafunctional habits was performed and correlated with the fracture of composite resin restorations. The information and data were tabulated and analyzed using descriptive statistics, COUNTIF function, and the results were expressed in tables. The most frequent parafunctional habits were bruxism, followed by onychophagia, occurring in greater quantity in females. A greater number of fractured restorations were found in patients with parafunctional habits. Among the parafunctional habits verified, it was concluded that bruxism was the most frequent, related mainly to the fracture of class V restorations.