Publications by authors named "Vanara Florêncio Passos"

17 Publications

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in Dentistry: Technological Prospection and Scientific Evidence.

Evid Based Complement Alternat Med 2021 30;2021:9966738. Epub 2021 Aug 30.

Department of Preventive and Community Dentistry, University of Buenos Aires, Buenos Aires, Argentina.

Purpose: This study aimed to evaluate reports of patents for oral care formulations, based on (), deposited and granted in intellectual property banks.

Methods: A survey was conducted through collection, treatment, and analysis of extracted information from patent reports selected. The documentary research was conducted in January 2021 on formulations with for dental applications, including since the first patent deposits until the current time. The risk of bias of clinical trials with these formulations was analyzed to verify the scientific evidence. The data extracted represent the distribution of the number of patents by banks, annual evolution of patent deposits, applicant of patents by country, distribution of patents according to International Patent Classification codes, and the types of patented products.

Results: Data and information from 20 selected patents were extracted. The United States Patent and Trademark Office (USPTO) and World Intellectual Property Organization (WIPO) were the banks with the largest number of patents for products/formulations with for oral care applications with 7 (35%) and 6 (30%) patent registrations, respectively. Other banks did not provide patents related to the search. Patents of compositions were the largest with 14 filings, and the remainder of formulations are represented specially by mouthwashes and toothpastes. As for clinical application, 18 patents were filed as products with antimicrobial and antibiofilm action, while 2 patents are directed to the treatment of xerostomia. In general, the aspects of the studies of clinical efficacy pointed to a low risk of bias.

Conclusion: The study pointed out a small number of products protected by patents for for oral care indication, highlighting mainly mouthwash compositions and formulations. In the methodological parameters of clinical trials carried out with the formulations, the majority pointed out a low risk of bias.
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August 2021

Hesperidin reduces dentin wear after erosion and erosion/abrasion cycling in vitro.

Arch Oral Biol 2021 Sep 19;129:105208. Epub 2021 Jul 19.

Department of Restorative Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Rua Monsenhor Furtado, s/nº, Fortaleza, CE, Brazil. Electronic address:

Objective: To evaluate the action of hesperidin (HPN) at different concentrations to prevent dentin erosive wear, associated or not to abrasion.

Methods: A study with 6 experimental groups (n = 10) for erosion (experiment 1) and another 6 for erosion + abrasion (experiment 2). The treatments were: distilled water (DW), DW with collagenase (DW + Col), 0.46% epigallocatechin-3-gallate (EGCG) and 0.1%, 0.5% or 1% HPN. The specimens were submitted to a cycle (3x/day) for 5 days that consisted of immersion on 1% citric acid (5 min), artificial saliva (60 min), treatment (5 min), brushing (150 movements only in experiment 2), and artificial saliva (60 min / overnight). Collagenase was added in artificial saliva for all groups except DW-group. Dentin changes were assessed with optical profilometry and scanning electron microscopy. Data were submitted to one-way analysis of variance and Tukey tests (α = 0.05).

Results: For experiment 1, DW showed the lowest wear and did not significantly differ from EGCG. DW + Col showed the highest wear, being significantly different from HPN at 1%. In experiment 2, DW showed the lowest wear and DW + Col the highest. EGCG showed less wear than the three groups treated with HPN. In addition, for both cycling models, there were no significant differences among the three concentrations of HPN analyzed. In micrographs of HPN-treated groups, it could be observed the formation of a barrier on the dentin that promoted the obliteration of the tubules.

Conclusions: HPN was able to preserve the demineralized organic matrix layer but did not overcome the effect of EGCG.
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September 2021

Fluoride dentifrice containing calcium silicate and sodium phosphate salts on dental erosion: In vitro study.

Arch Oral Biol 2020 Oct 2;118:104857. Epub 2020 Aug 2.

Federal University of Ceará, Department of Restorative Dentistry, Rua Monsenhor Furtado, s/nº, Fortaleza, Ceará, CEP 60430-350, Brazil. Electronic address:

Objective: To investigate the effect of a commercial dentifrice containing fluoride, calcium silicate, and sodium phosphate and its dual phase gel serum to prevent erosive tooth wear in enamel.

Methods: Forty-eight enamel specimens were selected by surface hardness and randomly allocated into 4 groups (n = 12) according to the commercial toothpastes: non-fluoridated (NF); 1100 ppm Stannous fluoride (SnF); 1450 ppm MFP + calcium silicate + sodium phosphate (CSSP); CSSP + dual-phase gel (CSSP + Serum). Cyclic experiments were repeated 3x / day for five days, including an erosive challenge with 0.05 M citric acid (pH 3.75 for 30 s), treatment with toothpaste slurries (1 min), and remineralization with artificial saliva (pH 7.0 for 60 min). Surface alterations were determined by stylus profilometry (μm) and scanning electron microscopy (SEM). Data were analyzed by ANOVA and Tukey tests (α = 0.05).

Results: SnF, CSSP and CSSP + Serum significantly reduce surface wear compared to NF treated group. Besides, there were no significant differences among SnF, CSSP and CSSP + Serum. In micrographs of both groups treated with CSSP, the surface demonstrates the presence of a protective layer as a deposition of particles.

Conclusions: Dentifrice containing calcium silicate and sodium phosphate with or without the dual-phase gel was able to prevent the erosive tooth wear.
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October 2020

Effect of Metalloproteinase Inhibitors on Bond Strength of a Self-etching Adhesive on Erosively Demineralized Dentin.

J Adhes Dent 2019 ;21(4):337-344

Purpose: To analyze the influence of epigallocatechin-3-gallate (EGCG) and chlorhexidine (CHX) on adhesive-dentin bond strength of a self-etch adhesive to sound dentin (SD) and eroded dentin (ED).

Materials And Methods: Thirty-six middle-dentin samples were assigned to six groups (n = 6) according to pretreatment (DW: distilled water, control; 0.1% EGCG; or 2% CHX) and erosive challenge (presence or absence). Specimens were subjected to 2-h acquired pellicle formation, then half of them were exposed to 1% citric acid three times a day for five days. SD and ED were treated with the tested solutions for 60 s, and then Clearfil SE Bond was applied before resin composite buildup. Bonded teeth were longitudinally sectioned into sticks and half were immediately tested, while the remaining specimens were tested after six months. The mode of fracture was examined and the microtensile bond strength (µTBS) measured. Statistical analysis was performed with ANOVA and Bonferroni tests.

Results: At both time periods, regardless of the dentin substrate, EGCG groups did not show bond strengths that were significantly different from those obtained with DW (p > 0.05), while CHX generated lower values than did DW (p < 0.05). On SD, there was a bond strength reduction only in the CHX groups after six months. However, for ED, the bond strength significantly decreased in all groups.

Conclusion: CHX negatively affected both dentin substrates, while the pretreatment with EGCG did not affect µTBS over time on SD. µTBS may be influenced by the substrate over time and EGCG can be used as an alternative to CHX to maintain the bond strength of self-etching adhesives.
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October 2019

Active compounds and derivatives of camellia sinensis responding to erosive attacks on dentin.

Braz Oral Res 2018 May 24;32:e40. Epub 2018 May 24.

Universidade Federal do Ceará - UFC, Faculty of Pharmacy, Dentistry and Nursing, Fortaleza, Ceará, Brazil.

This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm-1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.
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May 2018

Magnesium hydroxide-based dentifrice as an anti-erosive agent in an in situ intrinsic erosion model.

Am J Dent 2017 Jun;30(3):137-141

Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.

Purpose: To evaluate in situ a magnesium hydroxide-[Mg(OH)2] based dentifrice on enamel erosion.

Methods: Human dental enamel slabs were selected by surface microhardness and randomly assigned to one out of the following three groups (n=18): non-fluoride (control), NaF (1,450 ppm F), and Mg(OH)2 dentifrices. 18 volunteers were enrolled in a randomized, crossover and double-blind study, with three phases in 5 days. They wore acrylic palatal appliances containing two human enamel slabs, which were treated with one of the three dentifrices. During each experimental phase, the specimens were subjected to erosion by immersion in 0.01 M HCl for 60 seconds, 4x/day, followed by a 1-minute treatment with the correspondent slurry (saliva/dentifrice). Enamel changes were determined by the percentage of surface hardness loss (%SHL) and mechanical profilometry analysis. Data were analyzed by ANOVA, followed by Tukey's test (P< 0.05).

Results: The means (SD) for %SHL and surface wear (μm) were, respectively, as follows: control [50.67(17.48), 2.70(1.24) ], NaF [45.45(15.44), 1.95(0.70) ] and Mg(OH)2 [53.94(19.48), 1.95(0.67) ]. There was no statistically significant difference among the treated and control groups for %SHL (P= 0.349); however, for wear rates, a statistically significant difference was found between the groups treated with NaF and Mg(OH)2 and the control group (P= 0.04).

Clinical Significance: Dentifrices containing magnesium hydroxide or sodium fluoride might be an important strategy to minimize the effects of erosive challenges.
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June 2017

The effect of magnesium hydroxide-containing dentifrice using an extrinsic and intrinsic erosion cycling model.

Arch Oral Biol 2018 Feb 14;86:46-50. Epub 2017 Nov 14.

Universidade Federal do Ceará - UFC, Faculty of Pharmacy, Dentistry and Nursing, Monsenhor Furtado St., Fortaleza, CE, Brazil. Electronic address:

Objective: To evaluate, in vitro, the effect of Mg(OH) dentifrice, and the influence of the number of experimental days, on the extrinsic (citric acid -CA) and intrinsic (hydrochloric acid -HCl) enamel erosion models.

Design: Human enamel slabs were selected according to surface hardness and randomly assigned to 3 groups (n=9) as follows: non-fluoridated (negative control), NaF (1450ppm F- positive control) and Mg(OH) (2%) dentifrices. The slabs were daily submitted to a 2-h period of pellicle formation and, over a period of 5days, submitted to cycles (3×/day) of erosive challenge (CA 0.05M, pH=3.75 or HCl 0.01M, pH=2 for 30s), treatment (1min -1:3w/w of dentifrice/distilled water) and remineralization (artificial saliva/120min). Enamel changes were determined by surface hardness loss (SHL) for each day and mechanical profilometry analysis. Data were analyzed by two-way ANOVA followed by Tukey's test to % SHL and one-way ANOVA to profilometry (p<0.05).

Results: The number of experimental days influenced the erosion process for the two types of erosion models (p<0.001). Mg(OH)-containing dentifrices were effective in reducing enamel extrinsic acid erosion as determined by % SHL (p<0.001) when compared to the control group, being better than positive control (p<0.001); however, the dentifrices were not effective for the intrinsic model (p=0.295). With regards to surface wear, no statistically significant differences were found among the groups for CA (p=0.225) and HCl (p=0.526).

Conclusion: The findings suggest that Mg(OH) dentifrices might protect enamel against slight erosion, but protection was not effective for stronger acid erosion.
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February 2018

Carbohydrate-electrolyte drinks exhibit risks for human enamel surface loss.

Restor Dent Endod 2016 Nov 16;41(4):246-254. Epub 2016 Aug 16.

Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.

Objectives: The aim of this investigation was to give insights into the impact of carbohydrate-electrolyte drinks on the likely capacity of enamel surface dissolution and the influence of human saliva exposure as a biological protective factor.

Materials And Methods: The pH, titratable acidity (TA) to pH 7.0, and buffer capacity (β) of common beverages ingested by patients under physical activity were analyzed. Then, we randomly distributed 50 specimens of human enamel into 5 groups. Processed and natural coconut water served as controls for testing three carbohydrate-electrolyte drinks. In all specimens, we measured surface microhardness (Knoop hardness numbers) and enamel loss (profilometry, µm) for baseline and after simulated intake cycling exposure model. We also prepared areas of specimens to be exposed to human saliva overnight prior to the simulated intake cycling exposure. The cycles were performed by alternated immersions in beverages and artificial saliva. ANOVA two-way and Tukey HDS tests were used.

Results: The range of pH, TA, and β were 2.85 - 4.81, 8.33 - 46.66 mM/L and 3.48 - 10.25 mM/L × pH, respectively. The highest capacity of enamel surface dissolution was found for commercially available sports drinks for all variables. Single time human saliva exposure failed to significantly promote protective effect for the acidic attack of beverages.

Conclusions: In this study, carbohydrate-electrolyte drinks usually consumed during endurance training may have a greater capacity of dissolution of enamel surface depending on their physicochemical proprieties associated with pH and titratable acidity.
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November 2016

Effect of green tea as a protective measure against dental erosion in coronary dentine.

Braz Oral Res 2016 15;30. Epub 2015 Dec 15.

Faculty of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil.

The aim of this study was to evaluate the effect of green tea as a protective measure on eroded dentin. Disks of human coronary dentin were selected based on surface hardness and randomly assigned to 3 groups (n = 10): DW - distilled water, CHX - 0.2% chlorhexidine digluconate, and GT - green tea. The disks were allowed to acquire pellicle for 2 hours and were then subjected to 3 cycles per day of demineralization (C6H8O7 0.05 M, pH 3.75, 60 s), treatment (DW or CHX or GT, 5 min) and remineralization (artificial saliva, 60 min) over a period of 3 days. Changes in the dentin were determined by loss of surface hardness (%SHL) and mechanical profilometry analysis at the end of each day. Data were analyzed by two-way ANOVA followed by Tukey's test for %SHL and profilometry (p < 0.05). Significant reductions in dentin hardness loss were observed only for the CHX group when compared to the DW group (p < 0.05). However, there was no significant difference between the CHX and GT groups (p > 0.05). A significant difference was observed between DW and GT treatments for wear and roughness measurements (p < 0.05). The green tea extract solution was able to reduce the wear and roughness caused by dentin erosion under the conditions of this study.
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May 2016

Effect of commercial fluoride dentifrices against hydrochloric acid in an erosion-abrasion model.

Clin Oral Investig 2015 Jan 28;19(1):71-6. Epub 2014 Feb 28.

Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.

Objectives: This study assessed the effect of three commercial dentifrices with different fluoride-containing compounds in controlling the progression of dentin loss using an in vitro erosion-abrasion model.

Materials And Methods: Dentin specimens were randomized into four groups (n = 10): control (no F), Elmex (1,400 ppm AmF), Meridol (1,400 ppm AmF/SnF2), and Crest Pro-Health (1,100 ppm SnF2). The dentin specimens were submitted to cycles of demineralization (HCl 0.01 M for 60 s), remineralization (artificial saliva for 60 min), and immersion in 1:3 w/w of dentifrice/artificial saliva, followed by toothbrushing (150 brushing strokes). The cycle was repeated three times daily for 5 days. Surface loss was quantified by stylus profilometry. Data were submitted to one-way ANOVA and Tukey's tests (p < 0.05).

Results: Wear (μm ± SD) was control 4.1 ± 1.2, Elmex 3.7 ± 1.5, Meridol 1.3 ± 0.4, and Crest Pro-Health 2.1 ± 0.7. Therefore, all products (except Elmex) produced statistically significantly less mineral loss (p < 0.05) when compared with the control.

Conclusion: None of the dentifrices avoided the erosive-abrasive process; however, SnF2-containing dentifrices were effective in statistically significantly reducing dentin loss.

Clinical Relevance: Scientific literature shows evidence that fluoride can strengthen dental tissue against erosive acid damage. However, the beneficial effect of different fluorides present in commercial dentifrices is questionable. Thus, a determination of an effective fluoride dentifrice may be beneficial in the reduction of the erosive process in patients with gastric disorders.
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January 2015

Effects of 2 polishing techniques and reglazing on the surface roughness of dental porcelain.

Gen Dent 2013 Nov-Dec;61(7):e6-9

The aim of this study was to compare the effect of 2 polishing systems and reglazing of dental porcelain through a quantitative and qualitative analysis of surface roughness using a stylus profilometer and scanning electron microscope. Fifteen porcelain specimens (10 x 3 x 3 mm) were used. On 1 surface of each block, a layer of glaze was applied, and surface roughness (Ra) was analyzed. All specimens were ground with aluminum oxide sandpaper until the shine was removed and the resulting Ra values were obtained. Afterwards, they were randomly divided into 3 treatment groups (n = 5): Group I (GI), polished with diamond-impregnated rubber wheels; Group II (GII), polished with silicon carbide-impregnated rubber wheels; and Group III (GIII), reglazed firing procedure alone. After the treatments, new Ra measurements were done. Data were submitted to analysis of variance (ANOVA), and Tukey tests at 5%. Comparisons between ground surface and treated surface were made by paired t-test. The ground and treated Ra values (µm) were determined as follows: GI: 0.66 ± 0.14, 0.35 ± 0.06; GII: 0.60 ± 0.04, 0.09 ± 0.03; and GIII: 0.67 ± 0.05, 0.75 ± 0.24. Significant differences were found between the ground and treated values for all groups. After the treatments, all groups differed statistically (P < 0.05). The silicon carbide system re-established the initial surface smoothness, while polishing with diamond-impregnated rubber or reglazing alone were not able to achieve a satisfactory smoothness.
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September 2015

A conservative treatment approach using direct composite resins for anterior teeth eroded by lemon sucking.

Gen Dent 2013 Aug;61(5):e1-4

School of Dentistry, University of Fortaleza, CE, Brazil.

An excessively acidic diet results in the progressive deterioration of dental health, with functional, esthetic, and biological consequences. Previously, rehabilitation required placing numerous full crowns and root canal treatments; however, with improved adhesive techniques, a more conservative approach may be utilized to preserve tooth structure. This article describes 2 cases that utilized conservative dental treatments (involving direct composite resins with minimal preparation of the tooth structure) to treat eroded dentition induced by lemon sucking.
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August 2013

Restoring esthetics in eroded anterior teeth: a conservative multidisciplinary approach.

Gen Dent 2011 Jan-Feb;59(1):48-52

Department of Pharmacy, Dentistry, and Nursing, Federal University of Ceara, Fortaleza, CE, Brazil.

Consuming a highly acidic diet can lead to erosion or excessive wear of dental hard tissues, resulting in the need for oral rehabilitation. Previously, a severely eroded dentition could be rehabilitated only by extensive crown and bridge placement or by removable partial dentures. However, developments in adhesive dentistry have made it possible to restore the esthetics and function of eroded teeth in a minimally invasive manner. This case report presents a conservative, multidisciplinary approach to restoring severe wear due to dental erosion using proper techniques and materials.
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October 2011

Protective effect of NaF/triclosan/copolymer and MFP dentifrice on enamel erosion.

Am J Dent 2010 Aug;23(4):193-5

School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.

Purpose: To evaluate in situ the protective effect of sodium fluoride (NaF)/triclosan/copolymer dentifrice compared with monofluorphosphate (MFP) dentifrice on eroded enamel.

Methods: The specimens were subjected to erosion with cola soft drink for 60 seconds, four times a day, for 5 days, followed by treatment with the slurry of nonfluoridated, NaF (1450 ppm F/triclosan/copolymer) or MFP (1450 ppm F) dentifrices. Their effects were assessed by surface hardness loss.

Results: The dentifrice containing NaF/triclosan/copolymer was statistically more effective on reduction of enamel acid erosion than the non-fluoride and the MFP dentifrice (P < 0.05).
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August 2010

Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions.

Braz Dent J 2010 ;21(3):229-34

Federal University of Ceará, Fortaleza, CE, Brazil.

This controlled clinical trial evaluated the 2-year clinical performance of a one-bottle etch-and-rinse adhesive and resin composite system (Excite/Tetric Ceram) compared to a resin-modified glass ionomer cement (RMGIC) (Vitremer/3M) in non-carious cervical lesions. Seventy cervical restorations (35 resin composite - RC- restorations and 35 RMGIC restorations) were placed by a single operator in 30 patients under rubber dam isolation without mechanical preparation. All restorations were evaluated blindly by 2 independent examiners using the modified USPHS criteria at baseline, and after 6, 12 and 24 months. Data were analyzed statistically by Fisher's exact and McNemar tests. After 2 years, 59 out of 70 restorations were evaluated. As much as 78.8% retention rate was recorded for RC restorations, while 100% retention was obtained for RMGIC restorations. Fisher's exact test showed significant differences (p=0.011) for retention. However, there were no significant differences for marginal integrity, marginal discoloration, anatomic form and secondary caries between the RC and RMGIC restorations. The McNemar test detected significant differences for Excite/TC between baseline and the 2-year recall for retention (p=0.02), marginal integrity (p=0.002) and anatomic form (p=0.04). Therefore, the one-bottle etch-and-rinse bonding system/resin composite showed an inferior clinical performance compared to the RMGIC.
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June 2011

Clinical evaluation of a 3% potassium oxalate gel and a GaAlAs laser for the treatment of dentinal hypersensitivity.

Photomed Laser Surg 2009 Oct;27(5):807-12

Department of Restorative Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.

Objectives: This study evaluated the immediate and 3 month clinical effects of a low-level gallium-aluminum-arsenide (GaAlAs) laser and a 3% potassium oxalate gel for the treatment of dentinal hypersensitivity.

Materials And Methods: A total of 164 teeth from 30 patients with clinical diagnoses of dentinal hypersensitivity were selected for this randomized, placebo-controlled, double-blind clinical study. The teeth were randomized to three groups: GaAlAs laser, oxalate gel, and placebo gel. The treatment sessions were performed at 7 d intervals for four consecutive weeks. The degree of sensitivity in response to an air blast and tactile stimuli was assessed according to a visual analogue scale at baseline, immediately after the fourth application, and then 3 months after the fourth application. The reductions in dentinal hypersensitivity from baseline at the two follow-up assessments were evaluated as the main outcome.

Results: In both the active and control groups, there were statistically significant reductions in dentinal hypersensitivity immediately after and 3 months after the treatments, when compared with the hypersensitivity at baseline. No significant differences among the three groups could be detected in their efficacy at either the immediate or 3 month evaluations irrespective of the stimulus.

Conclusions: The treatments under study were effective for reducing dentinal hypersensitivity, and longer observational periods could enhance the ability of studies to detect differences between active and placebo groups.
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October 2009

One year clinical evaluation of two different types of composite resins in posterior teeth.

J Contemp Dent Pract 2008 May 1;9(4):26-33. Epub 2008 May 1.

Department of Operative Dentistry at the Federal University of Espírito Santo in Espírito Santo, Brazil.

Aim: The aim of this study was to assess the clinical performance of two adhesive restorative systems (Single Bond/Filtek P-60 and Single Bond/Filtek Z-250) in posterior teeth using a modified United States Public Health Service (USPHS) system.

Methods And Materials: A total of 70 restorations were placed in molars and premolars in 30 patients (14 females and 16 males; 18-40 years) by one operator. All restorations were directly evaluated by two examiners at baseline, six months, and 12 months using the following modified USPHS rating criteria: marginal integrity, marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries.

Results: At six and 12 months all restorations were available for evaluation of marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries that remained with 100% Alpha-ratings at recalls for both restorative systems. Marginal integrity for P-60 was scored as 94.3% and 91.4% Alpha at six and 12 months, respectively, and rates for Z-250 were 100% and 97.1% Alpha at six and 12 months, respectively. Statistical analysis was completed with Fisher's exact and McNemar Chi-square tests at a significance level of 5% (P<0.05).

Conclusion: All restorations were clinically satisfactory and no significant differences were found among them.

Clinical Significance: Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance.
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May 2008