The partial removal of carious dentine was studied by means of a literature review and a multicenter randomized controlled clinical trial. The clinical trial compared the effectiveness of an alternative treatment for deep caries lesions and the stepwise excavation in Public Health Services in Brazil. The treatment consists of partial removal of carious dentine followed by restoration in one session. A cost-effectiveness analysis the two treatments was performed. The clinical performance of amalgam and resin restorations placed in deep caries lesions with or without decayed tissue beneath them was also evaluated. Inclusion criteria: patients with ≥ nine years old, permanent molars with deep caries lesions and absence of periapical alterations, pulp sensitivity; absence of spontaneous pain; negative percussion test. The subjects were assigned to: test-group - partial removal of carious dentine (PDR) and restoration, and control-group - stepwise excavation (SW). SW consists of partial removal of carious tissue, indirect pulp capping with calcium hydroxide cement; temporary filling; cavity re-opening after 60 days, removal of the remaining soft carious tissue and filling. Clinical and radiological exams were performed annually. The outcomes were: (1) pulp sensitivity to cold test and absence of periapical alterations, assuming those parameters as indicators of pulp vitality; and (2) success of the restoration. To determine the cost-effectiveness of the treatments, the discounted cash flow method was adopted. The data were submitted to Kaplan-Meier, Log-rank test and logistic regression analysis, P<0.05. There were performed 299 treatments, 146 SW and 153 tests. There were no differences between the groups regarding baseline characteristics - age, gender and family income. The number of teeth evaluated after one and two years were 180 and 122. After one year of treatment performance, the therapy success rates were 97.9% and 74.1% of success in test and control groups respectively (P<0.000). After 2 years of follow-up, therapy survival rates of PDR and SW were 93.7% and 73.3% respectively (P=0.000). A total of 29 therapeutic failures were observed: PDR group - pulpitis (n=3), osteitis (n=1), hyperemia (n=2); SW group - pulpitis (n=15), necrosis (n=6), extraction (n=1) and restoration fracture (n=1). None of the variables studied showed a significant causal influence on the success rate, besides the type of treatment. After two year of follow-up, 181 restorations had been evaluated, 86 from the SW group and 95 from the PDR group; 65.8% were from the resin composite group and 34.2% were amalgam restorations. The survival analysis of the treatment associated with the filling material showed no difference in the rate of success (P=0.564). Regarding the treatment, both groups presented a similar rate of success: SW=95.3% and PDR=94.7% (P=0.928). Resin composite restorations presented 96.8% of success and amalgam restorations presented 94.1% of success (P=0.446). The reason for failure was fracture of filling material. The PDR provides an economy of R$ 143.37 (67.78%) per treatment compare to SW and 2.39% in the overall economy in the annual cost of the public health center. Partial caries removal could be performed as definitive treatment and the procedure of re-opening the cavity to remove the residual infected dentine is not necessary. The maintenance of carious dentine does not interfere in the maintenance of pulp vitality. The presence of decayed tissue in deep caries lesions does not seem to interfere with the survival of the restorations. Performing the partial removal of carious dentine in one session generates benefits for the public finances (direct economy), for the public health services (increase in number of treatments performed) and for the patients (comfort and time).

This thesis is concerned with how prehistoric infants were fed in different physical and cultural environments, and in particular what impact the economic, social, and epidemiological changes associated with the development of agriculture had on infant feeding practices. In order to examine these effects, stable isotope ratio analysis has been used to assess the duration of breastfeeding and weaning in a variety of prehistoric contexts. The first study is of Pitted Ware Culture hunter-gatherers at the site of Ajvide on Gotland, Sweden. Breastfeeding usually continued for at least two years, but there was some variation in supplementary foods, which is attributed to seasonal variations in resource availability. The second study analysed a number of Neolithic and early Bronze Age sites from south-east Poland. Breastfeeding duration varied both within and between sites and ranged from six months to five years. The third study found that the infant feeding practices of two Iron Age populations on Öland, Sweden, were very varied, and infants may have been fed differently depending on their social status. The fourth study is of the childhood diet in the Únětice Culture of south-west Poland. Individual diets changed little during the lifetime, suggesting that eventual adult identity was determined early in life. A small number of infants in the study were found to have breastfed for differing lengths of time. The final paper considers the health consequences of introducing animal milks into the infant diet in a prehistoric context, and finds that their availability is unlikely to have made it possible to safely wean infants earlier. Comparison of the results from the four stable isotope studies to those of other published studies reveals that the modal age at the end of weaning was slightly lower in agricultural communities than hunter-gatherer communities, but the range of ages was similar. Weaning prior to the age of eighteen months was rare before the post-medieval period. It is argued that the gradual reduction in breastfeeding duration since the Neolithic, and the replacement of breastmilk with animal milk products, means that on the whole the development of agriculture probably served to increase infant morbidity and mortality. / <p>At the time of doctoral defense the following papers were unpublished and had a status as follows: Paper 1: Manuscript; Paper 4: Accepted; Paper 5: Forthcoming 2014</p> / Lactase Persistence and the early Cultural History of Europe (LeCHE)

Background There is a transition towards minimally invasive restorative techniques in restorative dentistry based upon reducing bacterial viability and encouraging remineralization of caries infected tissue. To improve the predictability of the antibacterial and remineralization potential of carious dentine by either the application of medicaments or placement of restorative materials that encourage remineralization would be a significant benefit in disease management. Materials and Methods An experimental model was developed using a chemostat for in vitro analysis of the effects of silver fluoride followed by potassium iodide (AgF/KI) and ozone treatment on non demineralized and demineralized dentine. Electron Probe Micro Analysis (EPMA) and Scanning Electron Microscopy (SEM) on the treated dentine were conducted to investigate ion transfer, and biofilm formation. Bacteria growth was measured by optical density. An in vitro caries model using a chemostat was developed to determine the ability of glass ionomer cement and composite resin to inhibit dentinal degradation in adjacent dentine and to measure ion exchange at the restorative interface. Tests were made to determine the bond strength between dentine and glass ionomer cement after application of silver fluoride to the surface of the dentine. Results S. mutans migrated through all dentine samples. Samples treated with AgF/KI had significantly lower optical densities than the corresponding controls. Optical density readings were significantly lower in demineralized dentine treated with AgF/KI than non demineralized dentine. There were lower but not significant differences in the optical density readings between ozonated and non ozonated dentine. An S. mutans biofilm covered all control discs. No biofilm was detected on discs treated with AgF/KI and these discs were significantly more resistant to further demineralization than the control discs. Detectable amounts of silver and fluoride were found up to 450 μm in the AgF and AgF/KI sections. Ozone infusion prevented S. Mutans and L. acidophilus biofilm formation on all the treated dentine samples, biofilm was present on all control specimens. There was calcium and phosphorus present in all auto cure glass ionomer cements to a depth beyond 50 microns. Aluminium and strontium ions were also present in dentine except strontium subjacent to Ketac Molar restorations. Fluoride uptake was significantly higher under glass ionomer cement restorations where the dentine was pretreated with AgF/KI compared to non treated specimens. Silver and iodine deposits were present in demineralized dentine treated with AgF/KI. Calcium and phosphorus levels up to 130 microns from the restorative interface were similar to non demineralized dentine adjacent to auto cure glass ionomer cements and half that adjacent to composite resin. There was significant surface degradation in auto cure glass ionomer cements compared to composite resin. Washing away the AgF/KI precipitate produced higher bond strengths to dentine than samples where the precipitate remained. Conclusions Under the conditions of these in vitro studies, the application of AgF/KI and ozone pharmacologically reduces the initiation and rate of dentine caries. Glass ionomer cements were shown to protect dentine from experimental carious degradation and assist with remineralization. AgF/KI application enhances remineralization beneath glass ionomers and does not interfere with bond strengths. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1344616 / Thesis (Ph.D.) - University of Adelaide, Dental School, 2008

The partial removal of carious dentine was studied by means of a literature review and a multicenter randomized controlled clinical trial. The clinical trial compared the effectiveness of an alternative treatment for deep caries lesions and the stepwise excavation in Public Health Services in Brazil. The treatment consists of partial removal of carious dentine followed by restoration in one session. A cost-effectiveness analysis the two treatments was performed. The clinical performance of amalgam and resin restorations placed in deep caries lesions with or without decayed tissue beneath them was also evaluated. Inclusion criteria: patients with ≥ nine years old, permanent molars with deep caries lesions and absence of periapical alterations, pulp sensitivity; absence of spontaneous pain; negative percussion test. The subjects were assigned to: test-group - partial removal of carious dentine (PDR) and restoration, and control-group - stepwise excavation (SW). SW consists of partial removal of carious tissue, indirect pulp capping with calcium hydroxide cement; temporary filling; cavity re-opening after 60 days, removal of the remaining soft carious tissue and filling. Clinical and radiological exams were performed annually. The outcomes were: (1) pulp sensitivity to cold test and absence of periapical alterations, assuming those parameters as indicators of pulp vitality; and (2) success of the restoration. To determine the cost-effectiveness of the treatments, the discounted cash flow method was adopted. The data were submitted to Kaplan-Meier, Log-rank test and logistic regression analysis, P<0.05. There were performed 299 treatments, 146 SW and 153 tests. There were no differences between the groups regarding baseline characteristics - age, gender and family income. The number of teeth evaluated after one and two years were 180 and 122. After one year of treatment performance, the therapy success rates were 97.9% and 74.1% of success in test and control groups respectively (P<0.000). After 2 years of follow-up, therapy survival rates of PDR and SW were 93.7% and 73.3% respectively (P=0.000). A total of 29 therapeutic failures were observed: PDR group - pulpitis (n=3), osteitis (n=1), hyperemia (n=2); SW group - pulpitis (n=15), necrosis (n=6), extraction (n=1) and restoration fracture (n=1). None of the variables studied showed a significant causal influence on the success rate, besides the type of treatment. After two year of follow-up, 181 restorations had been evaluated, 86 from the SW group and 95 from the PDR group; 65.8% were from the resin composite group and 34.2% were amalgam restorations. The survival analysis of the treatment associated with the filling material showed no difference in the rate of success (P=0.564). Regarding the treatment, both groups presented a similar rate of success: SW=95.3% and PDR=94.7% (P=0.928). Resin composite restorations presented 96.8% of success and amalgam restorations presented 94.1% of success (P=0.446). The reason for failure was fracture of filling material. The PDR provides an economy of R$ 143.37 (67.78%) per treatment compare to SW and 2.39% in the overall economy in the annual cost of the public health center. Partial caries removal could be performed as definitive treatment and the procedure of re-opening the cavity to remove the residual infected dentine is not necessary. The maintenance of carious dentine does not interfere in the maintenance of pulp vitality. The presence of decayed tissue in deep caries lesions does not seem to interfere with the survival of the restorations. Performing the partial removal of carious dentine in one session generates benefits for the public finances (direct economy), for the public health services (increase in number of treatments performed) and for the patients (comfort and time).

The partial removal of carious dentine was studied by means of a literature review and a multicenter randomized controlled clinical trial. The clinical trial compared the effectiveness of an alternative treatment for deep caries lesions and the stepwise excavation in Public Health Services in Brazil. The treatment consists of partial removal of carious dentine followed by restoration in one session. A cost-effectiveness analysis the two treatments was performed. The clinical performance of amalgam and resin restorations placed in deep caries lesions with or without decayed tissue beneath them was also evaluated. Inclusion criteria: patients with ≥ nine years old, permanent molars with deep caries lesions and absence of periapical alterations, pulp sensitivity; absence of spontaneous pain; negative percussion test. The subjects were assigned to: test-group - partial removal of carious dentine (PDR) and restoration, and control-group - stepwise excavation (SW). SW consists of partial removal of carious tissue, indirect pulp capping with calcium hydroxide cement; temporary filling; cavity re-opening after 60 days, removal of the remaining soft carious tissue and filling. Clinical and radiological exams were performed annually. The outcomes were: (1) pulp sensitivity to cold test and absence of periapical alterations, assuming those parameters as indicators of pulp vitality; and (2) success of the restoration. To determine the cost-effectiveness of the treatments, the discounted cash flow method was adopted. The data were submitted to Kaplan-Meier, Log-rank test and logistic regression analysis, P<0.05. There were performed 299 treatments, 146 SW and 153 tests. There were no differences between the groups regarding baseline characteristics - age, gender and family income. The number of teeth evaluated after one and two years were 180 and 122. After one year of treatment performance, the therapy success rates were 97.9% and 74.1% of success in test and control groups respectively (P<0.000). After 2 years of follow-up, therapy survival rates of PDR and SW were 93.7% and 73.3% respectively (P=0.000). A total of 29 therapeutic failures were observed: PDR group - pulpitis (n=3), osteitis (n=1), hyperemia (n=2); SW group - pulpitis (n=15), necrosis (n=6), extraction (n=1) and restoration fracture (n=1). None of the variables studied showed a significant causal influence on the success rate, besides the type of treatment. After two year of follow-up, 181 restorations had been evaluated, 86 from the SW group and 95 from the PDR group; 65.8% were from the resin composite group and 34.2% were amalgam restorations. The survival analysis of the treatment associated with the filling material showed no difference in the rate of success (P=0.564). Regarding the treatment, both groups presented a similar rate of success: SW=95.3% and PDR=94.7% (P=0.928). Resin composite restorations presented 96.8% of success and amalgam restorations presented 94.1% of success (P=0.446). The reason for failure was fracture of filling material. The PDR provides an economy of R$ 143.37 (67.78%) per treatment compare to SW and 2.39% in the overall economy in the annual cost of the public health center. Partial caries removal could be performed as definitive treatment and the procedure of re-opening the cavity to remove the residual infected dentine is not necessary. The maintenance of carious dentine does not interfere in the maintenance of pulp vitality. The presence of decayed tissue in deep caries lesions does not seem to interfere with the survival of the restorations. Performing the partial removal of carious dentine in one session generates benefits for the public finances (direct economy), for the public health services (increase in number of treatments performed) and for the patients (comfort and time).

Durante o processo inicial da reação de presa, o cimento de ionômero de vidro modificado por resina (CIVMR) apresenta baixo módulo de elasticidade, característica importante quando utilizado como base de restaurações com resina composta, por diminuir o estresse de contração de polimerização nas paredes cavitárias. O presente estudo teve como objetivo analisar a influência da técnica de polimerização de uma base CIVMR (VitrebondTM) por resina na interface dente/restauração de resina composta, através de teste de microtração e análise em microscopia confocal. Foram utilizados 30 dentes molares humanos hígidos extraídos, nos quais foram confeccionadas cavidades padronizadas em sua face oclusal (5mm de comprimento x 3mm de largura x 4,5mm profundidade). O sistema adesivo utilizado AdperTM Single Bond 2 foi marcado previamente com Rodamina B (0,16mg/ml), para possibilitar a análise em microscópio confocal. Os dentes foram divididos em 3 grupos: Grupo 1 (controle): base de CIVMR VitrebondTM + fotoativação + sistema adesivo + resina composta FiltekTM Z250; Grupo 2: base de CIVMR VitrebondTM + sistema adesivo + fotoativação por 30 segundos simultânea dos dois materiais + resina composta FiltekTM Z250; Grupo 3: base de CIVMR por resina VitrebondTM + tempo de espera de 60 segundos + fotoativação + sistema adesivo + resina composta FiltekTM Z250. Após a restauração, os dentes permaneceram em água deionizada em estufa a 37 ºC por 24 horas. Em seguida, foram seccionados com disco de diamante em fatias de aproximadamente 0,8mm no sentido vestíbulo-lingual. Uma fatia de cada dente foi separada aleatoriamente para análise da presença de fendas na interface dentina/resina composta em microscopia confocal. As demais fatias foram seccionadas para a confecção de palitos, para os testes de microtração. Os resultados de resistência de união foram submetidos à análise de variância a um critério ANOVA a 5% e teste de qui-quadrado para as variáveis de presença de fendas marginais e tipo de fratura resultante (p<0,05). Não houve diferença estatisticamente significante entre os três grupos (p=0,644) com relação à resistência adesiva e tipo de fratura, predominando a fratura do tipo adesiva para todos os grupos. Quanto à presença de fendas marginais internas, foi evidenciada sua presença nos grupos 2 e 3, sem diferença estatisticamente significante entre os três grupos testados (p=0,082). Conclui-se, portanto, que a técnica de polimerização da base de cimento de ionômero de vidro modificado por resina não influencia na resistência adesiva da interface dente/restauração de resina composta. / During the initial process of setting reaction, the resin-modified glass-ionomer cement (RMGIC) shows low modulus of elasticity, which is an important characteristic when RMGIC is used as a liner in resin composites restorations, because it decreases the polymerization shrinkage stress in cavity walls. The aim of this study was to analyze the influence of polymerization techniques of resin-modified glass-ionomer cement used as a liner on the adhesive interface dentin/resin by microtensile test and confocal microscopic analysis. Standardized occlusal cavity preparations (5mm length x 3mm wide x 4.5mm depth) were prepared in 30 human extracted molars. For the analysis at the confocal microscope, the adhesive system AdperTM Single Bond 2 was previously marked with rodhamine B (0.16mg/ml). The tooth were divided into three groups: Group 1 (control): RMGIC liner VitrebondTM + photoactivation for 30 seconds + adhesive system + resin composite Filtek TM Z250; Group 2: RMGICs liner VitrebondTM + adhesive system + simultaneous photoactivation of both materials + resin composite FiltekTM Z250; Group 3: RMGICs liner VitrebondTM+ 60 seconds delay time + photoativation for 30 seconds + adhesive system + resin composite FiltekTMZ250. Specimens were stored at 37ºC in deionized water for 24 hours. After this period, tooth was sectionated in 0.8mm slices (buco-lingual). One slice of each tooth was randomly selected for confocal microscopy for analysis of the interface resin/dentin. The other slices were sectionated in sticks (mesio-distal) for microtensile test. One-way ANOVA (p<0.05) showed no significant statistical difference among groups 1, 2 and 3 (p=0.644). Quisquare test showed no significant statistical difference of type of fracture (adhesive fracture was predominant) and presence of gap at the interface dentin/resin among groups. (p=0.082). It can be concluded, that polymerization technique of resin-modified glassionomer cement (RMGIC) did not influence bond strength and dentin/resin composite interface.

Submitted by Luanna Matias (lua_matias@yahoo.com.br) on 2015-03-09T11:19:12Z No. of bitstreams: 2 Tese - Fernanda Ribeiro Santana - 2012.pdf: 12111889 bytes, checksum: 84cf2d3d0d514483cc202fde5fa79301 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luanna Matias (lua_matias@yahoo.com.br) on 2015-03-09T14:09:39Z (GMT) No. of bitstreams: 2 Tese - Fernanda Ribeiro Santana - 2012.pdf: 12111889 bytes, checksum: 84cf2d3d0d514483cc202fde5fa79301 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-09T14:09:39Z (GMT). No. of bitstreams: 2 Tese - Fernanda Ribeiro Santana - 2012.pdf: 12111889 bytes, checksum: 84cf2d3d0d514483cc202fde5fa79301 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-05-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Aim: To evaluate in vitro the influence of root canal instrumentation techniques, endodontic irrigants, endodontic sealers and artificial accelerated aging on fibreglass post bond strength to bovine intraradicular dentine. Methodology: Part 1. 120 bovine incisors were divided into 12 experimental groups (n=10) resulting from the interaction among 3 study factors: root canal instrumentation technique (RCPSS- root canal preparation with stainless steel instruments - KFile; RCPNiTi- root canal preparation with K3 Nickel-Titanium instruments), endodontic irrigant (NaOCl- 1% sodium hypochlorite; CHX- 2% chlorhexidine; O3- 1.2% ozonated water) (in all samples 17% EDTA was used to remove the smear layer) and specimens artificial accelerated aging (Immediate, test with no aging; Mediate, test performed after 2 months of water storage at 37°C). After root canal preparation, endodontic filling was not performed. Fibreglass posts were cemented with self-adhesive resin cement (RelyX U100, 3M-ESPE) and roots were cross-sectioned to obtain two slices of each third. Samples were submitted to micropush-out test and bond strength values (MPa) were analyzed by ANOVA in a split-plot arrangement and Tukey’s test (α = 0.05). Failure modes were evaluated under a confocal microscope. Part 2. 60 bovine incisors were divided into 6 experimental groups (n=10) resulting from the interaction between 2 study factors: endodontic sealer (Sx- Sealapex; S26- Sealer 26; AHAH Plus) and specimens artificial accelerated aging (Immediate, test with no aging; Mediate, test performed after 2 months of water storage at 37°C). Two control groups were employed (without root canal filling), represented by groups RCPNiTiNaOCl immediate and RCPNiTiNaOCl mediate of part 1 of the present study. In the six experimental groups, root canals were prepared 1mm from the apex with K3 Nickel-Titanium instruments associated with 1% sodium hypochlorite irrigation and 17% EDTA. They were then filled with gutta-percha and the specific sealer of each group, using the lateral compaction technique. Fibreglass posts were cemented with self-adhesive resin cement (RelyX U100, 3M-ESPE) and roots were cross-sectioned to obtain two slices of each third. Abstract xx Samples were submitted to micropush-out test and bond strength values (MPa) were submitted to ANOVA in a split-plot arrangement and Tukey’s test (α = 0,05). Comparisons with control groups were made using Dunnet test (α = 0.05). Failure modes were evaluated under a confocal microscope. Results: Part 1. In specimens submitted to water artificial aging, RCPNiTi presented higher bond strength values than RCPSS in apical third irrigated with NaOCl or CHX. Irrigation with NaOCl resulted in higher bond strength than O3. Artificial aging resulted in significant bond strength increase, except for middle and apical thirds of RCPSSO3 and apical of RCPNiTiO3. Bond strength significantly reduced in apical third. The prevalence of adhesive cement-dentine failure was verified in all groups. Part 2. Endodontic sealers showed no significant differences among them, however they presented significantly lower bond strength values than control groups (without filling), except in cervical third of groups tested immediately. Artificial aging did not interfere on bond strength to intraradicular dentine. There was a significant decrease on bond strength from cervical to apical third. The prevalence of adhesive cement-dentine failure was verified in all groups. Conclusions: Part 1. Root canal preparation with NiTi instruments associated with NaOCl irrigation and EDTA increased the bond strength of fiberglass posts cemented with self-adhesive resin cement to intraradicular dentine. Part 2. Endodontic sealers interfered negatively on bonding of fibreglass posts cemented with self-adhesive resin cement to intraradicular dentine. / Objetivo: Analisar in vitro a influência das técnicas de instrumentação do canal radicular, dos irrigantes e cimentos endodônticos e do envelhecimento artificial acelerado na resistência de união do pino de fibra de vidro à dentina intrarradicular em dentes bovinos. Metodologia: Parte 1. Cento e vinte incisivos bovinos foram divididos em doze grupos experimentais (n=10) resultantes da interação entre três fatores em estudo: técnica de instrumentação do canal radicular (PAI – preparo do canal radicular com instrumentos de aço inoxidável - K-File; PNiTi – preparo do canal radicular com instrumentos de Níquel-Titânio - K3); irrigante endodôntico (NaOCl- hipoclorito de sódio 1%; CHX- clorexidina 2%; O3- água ozonificada 1,2%) (em todas as amostras o EDTA 17% foi utilizado para a remoção de smear layer) e envelhecimento artificial acelerado dos espécimes (Imediato, teste sem envelhecimento; Mediato, teste após 2 meses de envelhecimento em água a 37°C). Após o preparo dos canais radiculares não foi realizada a obturação endodôntica. Pinos de fibra de vidro foram cimentados com cimento resinoso auto-adesivo (RelyX U100, 3M-ESPE) e as raízes foram seccionadas para obtenção de duas fatias de cada terço. As amostras foram submetidas ao teste de micropush-out e os dados de resistência de união (MPa) foram analisados por ANOVA com parcela subdividida e teste de Tukey (α = 0,05). Os padrões de falha foram avaliados por meio de microscopia confocal. Parte 2. Sessenta incisivos bovinos foram divididos em seis grupos experimentais (n=10) resultantes da interação entre dois fatores em estudo: cimento endodôntico (SX- Sealapex; S26- Sealer 26; AH- AH Plus) e envelhecimento artificial acelerado dos espécimes (Imediato, teste sem envelhecimento; Mediato, teste após 2 meses de envelhecimento em água a 37°C). Foram empregados dois grupos controles (sem obturação do canal radicular) representados pelos grupos PNiTiNaOCl imediato e PNiTiNaOCl mediato da parte 1 do presente estudo. Nos seis grupos experimentais os canais radiculares foram preparados 1mm aquém do ápice com instrumentos de Níquel-Titânio - K3 associado a Resumo xviii irrigação com NaOCl 1% e EDTA 17%. Em seguida, foram obturados com gutapercha e o cimento endodôntico específico de cada grupo, usando a técnica de condensação lateral. Pinos de fibra de vidro foram cimentados com cimento resinoso auto-adesivo (RelyX U100, 3M-ESPE) e as raízes foram seccionadas para obtenção de duas fatias de cada terço. As amostras foram submetidas ao teste de micropush-out e os dados de resistência de união (MPa) foram analisados por ANOVA com parcela subdividida e teste de Tukey (α = 0,05). Comparações com os grupos controles foram feitas pelo teste de Dunnet (α =0,05). Os padrões de falha foram avaliados por meio de microscopia confocal. Resultados: Parte 1. Nos espécimes submetidos ao envelhecimento artificial em água, PNiTi apresentou maiores valores de resistência de união que PAI no terço apical irrigado com NaOCL ou CHX. A irrigação com NaOCL resultou em maior resistência de união comparada a O3. O envelhecimento artificial resultou em aumento significante da resistência de união, exceto para os terços médio e apical de PAIO3 e apical de PNiTiO3. A resistência de união reduziu significativamente no terço apical. A prevalência de falha adesiva cimentodentina foi verificada em todos os grupos. Parte 2. Os cimentos endodônticos não mostraram diferenças significantes entre si, entretanto apresentaram valores de resistência de união significativamente menores que os grupos controles (sem obturação), exceto no terço cervical dos grupos testados imediatamente. O envelhecimento artificial não interferiu na resistência de união à dentina intrarradicular. Houve uma diminuição significante na resistência de união do terço cervical para o apical. A prevalência de falha adesiva cimentodentina foi verificada em todos os grupos. Conclusões: Parte 1. O preparo do canal radicular com instrumentos de NiTi associado a irrigação com NaOCl e uso do EDTA aumentou a resistência de união de pinos de fibra de vidro cimentados com cimento auto-adesivo à dentina intrarradicular. Parte 2. Os cimentos endodônticos interferiram negativamente na união de pinos de fibra de vidro cimentados com cimento auto-adesivo à dentina intrarradicular.

Made available in DSpace on 2014-08-20T14:30:11Z (GMT). No. of bitstreams: 1 Tese _ Elenara_Ferreira_ Oliveira.pdf: 694369 bytes, checksum: 410d5111d12d3fad68258a97ba292b1b (MD5) Previous issue date: 2006-10-16 / This paper assesses clinical/radiographic changes after incomplete carious dentine removal and tooth sealing. 32 teeth with deep caries lesions were studied. The treatment consisted of incomplete excavation, application of Ca (OH)2 layer, sealing for a 6-7 month period, and then restored. Standardized bitewing radiographs were taken after the temporary sealing, and at 6-7, 14-18, and 36-45 month intervals. The digitized images were analyzed: qualitatively in regard to the radiolucent zone (RZ) depth and tertiary dentine (6-7 and 36-45 months) and quantitatively in regard toradiographic density by image subtraction (6-7, 14-18, and 36-45 months). The subtractions were performed in the RZ beneath the restoration and in two control areas (CA). During the 6-7 month period, there was 1 pulp necroses and 1 pulpexposure, and at the 36-45 month interval, 3 fractures and 3 withdrawals. Nine cases showed a decrease in RZ depth in the 6-7 month period and 3 more cases, at the 36- 45 month period. Four cases displayed tertiary dentine. The radiographic density means and standard deviations were: 129.42±5.83, 127.65±4.67, and 126.86±7.03 (CA, P>0.05) and 132.96 ±7.41, 132.90±5.99, and 132.62±8.68 (RZ, P>0.05) for the 1st, 2nd, and 3rd periods. The radiographic density of the CA differed from the RZ (Tukey test, p<0.05). Interference in microbiological metabolism by partial dentine removal and by tooth sealing arrest lesion progression, suggesting that complete dentine caries removal is not essential to controlling caries progression. / Este trabalho avaliou alterações clínicas/radiográficas após a remoção incompleta da dentina cariada e selamento do dente. Trinta e dois dentes com lesões profundas de cárie foram estudados. O tratamento consistiu da escavação incompleta da dentina cariada, aplicação de uma camada de cimento de Ca(OH)2, selamento provisório por um período de 6-7 meses, e restauração. Radiografias interproximais foram feitas logo após o selamento temporário e em intervalos de 6-7, 14-18, e 36-45 meses. As imagens digitalizadas foram analisadas: qualitativamente em relação à profundidade da zona radiolúcida (ZR) e deposição de dentina terciária (6-7 e 36-45 meses) e quantitativamente, em relação à densidade radiográfica, através da subtração de imagem (6-7, 14-18, e 36-45 meses). As subtrações foram realizadas na ZR, abaixo da restauração, e em duas áreas controles (AC). Durante período de 6-7 meses houve uma necrose e uma exposição pulpar, e no intervalo de 36-45 meses, três fraturas e três perdas de pacientes. Nove casos mostraram uma diminuição da profundidade da ZR no período de 6-7 meses e mais três casos no intervalo de 36-45 meses. Em quatro casos foi observada a deposição de dentina terciária. As médias de densidade radiográfica e desvio-padrão foram: 129.42±5.83, 127.65±4.67, e 126.86±7.03 (AC, p>0.05) e 132.96±7.41, 132.90±5.99, e 132.62±8.68 (ZR, p>0.05) para o 1º, 2º e 3º períodos, respectivamente. A densidade radiográfica das AC foi diferente da ZR (teste de Tukey, p<0.05). A interferência no metabolismo microbiano promovida pela remoção parcial da dentina cariada e selamento do dente provocou a paralisação da lesão, sugerindo que a remoção completa da dentina cariada não é essencial para o controle da progressão da cárie.

Made available in DSpace on 2014-08-20T14:30:20Z (GMT). No. of bitstreams: 1 Mabel Salas_DISSERTACAO.pdf: 6552657 bytes, checksum: 11efe494170784ff76d8fc2f0dff8e56 (MD5) Previous issue date: 2005-06-10 / Actually different alternatives to restored teeth with endodontical treatment are propose, otherwise with the advented of adhesive systems their use as luting endodontical cements and bonding resin cement for fiber posts are common. However the inherent characteristics behavior of these materials and the different variances presented at root canal, turns them sensible to failure. The aime of the study was to evaluated: a) the influence of two luting cements: containing eugenol (Endofill) and containing resin materials (Ahplus) on dentin bonding strength using push-out test at cervical, medium and apical root dentin regions, using two different 37% phosphoric acid viscosities: gel and liquid: b) the effect of the total-etching acid process on the pattern observed of the conditioned dentine substrate, c) Characterize the dentinal surface at different root regions d) Classify the fracture patterns between the substrate and the resin cement at three root regions. One hundred and four uniradicular teeth without caries lesions, extracted by orthodontics or periodontal reasons, with 7mm of diameter and 14mm of length were selected, disinfected in 0,5% chloramine and storage in distillated water at 5ºC. Endodontical canal treatments were performed using the Step-back technique and obturated with Endofill and AHplus. The preparation of the post space was 11mm depth using standardized rotary instruments. The total-etching with the gel and liquid acid were performed. The fiber posts were marked at the same depth, cuted, dry and silanized. Then two coats of Prime&bond 2,1 previously mixed with the self-cure activator, were applied at the post surface and into de root canal, after 1 minute the post were photocured (halogen light intensity of 450mW). The resin cement was mixed and placed into de canal using a lentuloespiral instrument. The posts were placed and a static force of 5kg for 10 minutes were applied, after words both adhesive and cement were photocured for 40 seconds, storage for 24 h in 37ºC, and embedded in a poliestyren resin. Cross-sectional cuts were obtained for the push-out test. The test were performed at a crosshead speed of 0,5mm/min, and a plane 20 cylindrical point was applied at the post centre. The maxim load was calculated in Mpa. The adhesive area was calculated using a tapered-cone shaped formula. The results were subjected to statistical analysis using a ANOVA test for multiple variables and a Pos Doc test(p<0,05) Statistically significant differences were detected between all the evaluated criterias: acids, cements and regions, and when they were inter-relationated between them. It was concluded that the use of 37% of phosphoric acid in a liquid form, allows a better penetration into the root canal, a uniform decalcification, consequently enhancing the bonding strength of the root dentine, particularly at apical region. / Actualmente diversos tipos de alternativas para restaurar dentes submetidos a tratamento endodontico são propostos, dentre estes, sistemas adesivos resinosos cimentantes para uso endodontico e pinos de fibra. No entanto as carateristicas inerentes apresentadas por estes materiais e as diversas variáveis presentes em nível radicular os fazem sensíveis a falhas. O objetivo deste trabalho foi avaliar a influência do tipo de cimento endodôntico e da viscosidade do ácido sobre a resistência de união de um sistema adesivo utilizando pinos de fibra de vidro, mediante o teste push-out e MEV em três níveis radiculares: cervical, médio e apical. Foram selecionados 104 dentes uniradiculares sem cárie, extraídos por motivos periodontais ou ortodônticos. Os dentes foram desinfectados em cloramina 0,5% e armazenados em água destilada a 5ºC. Os tratamentos endodônticos foram padronizados com a técnica step-back, obturando-se com Ahplus ou com Endofill. Os preparos para os pinos foram de 11mm padronizando os instrumentos. O condicionamento com o ácido fosfórico a 37%, em gel ou em líquido, foi realizado em ambos grupos. Os pinos de vidro foram seccionados em 11 mm,, silanizados, cobertos com duas camadas de Prime&bond 2.1 misturado previamente com o ativador de autopolimerização. O cimento resinoso Enforce (Dentsply) foi misturado e aplicado no canal utilizando lentulo. O pino era inserido e aplicava-se uma força padronizada de 5kg durante 10 min e sendo polimerizados por 40 seg, e armazenados por 24 horas a 37ºC, incluídos em resina de polietileno, cortados em 6 discos transversais de 1,5mm e lixados. O teste de push-out foi com uma velocidade de 0,5 mm/min, a ponta ativa cilíndrica plana (0,9 mm de diâmetro) era aplicada no centro do pino. A carga máxima foi convertida em MPa.. As diferenças entre os grupos foram determinadas mediante a análise de variância de ANOVA de três critérios, teste de Post Hoc (p<0,05). De acordo com a análise de fratura foram observadas diferenças nos três terços estudados particularmente no terço apical. Segundo a análise de fratura, foram observados quatro padrões diferentes de fraturas. Todas as variáveis testadas influenciaram significativamente a 18 resistência de união. A região cervical produziu geralmente menores valores de união, quando era utilizado o ácido em gel. Por outro lado, quando era utilizado o ácido em líquido os valores de resistência aumentavam, podendo-se concluir que a utilização de ácido fosfórico 37% em líquido permite uma maior penetração do adesivo no canal radicular produzindo um aumento da resistência de união na dentina radicular, particularmente no terço apical.

Historical evidence from contemporary documents established that Irish migrants to London during the Great Irish Famine (1845-1852) were likely to come from low socio-economic groups in south-west Ireland, and has characterised mid-19th-century health status and living conditions in both locations. Using samples from 119 individuals from the Catholic cemetery at Lukin Street, London (1843-1854) and 20 from the Union Workhouse Famine cemetery, Kilkenny, Ireland (1847-51), mean bone collagen isotope values were established for the well-documented Irish pre-Famine potato-based diet (¿15N 10.6¿, ¿13C -19.1¿), and the diet of contemporaneous Londoners (¿15N 12.6¿, ¿13C -19.1¿). The introduction of maize as a short-term Famine relief food was identified in three Kilkenny juveniles with bone collagen ¿13C above -17¿, and incremental dentine collagen demonstrating temporal changes in ¿13C consistent with dietary change from C3 to C4 plants. Bone collagen values for two Lukin Street individuals were consistent with high marine protein consumption. Techniques developed in this study to sample increments of dentine representing nine months or less of life have improved temporal resolution not only for migration events but also short-term dietary changes and physiological status during childhood. Combining epigraphic, osteological and archaeological evidence, individual ¿lifeways¿ have been constructed using isotope data and provide insights into the connection between health, diet and skeletal manifestations of deprivation during childhood and adolescence. New models are investigated for examining maternal and infant health using dentine collagen increments formed in utero and combining dentine and bone collagen values to explore the effects of nutritional stress on bone turnover. / Arts and Humanities Council. The British Federation of Women Graduates (the Eila Campbell scholarship). The British Association for Biological, Anthropology and Osteoarchaeology (the Jane Moore prize).