Made available in DSpace on 2014-08-20T14:30:13Z (GMT). No. of bitstreams: 1 Tese_Silvia_Terra_Fontes.pdf: 622962 bytes, checksum: 7bf1877d5a2267c9c8ee6f9619480978 (MD5) Previous issue date: 2011-12-16 / During restorative procedures, different isolation methods of the operative field can be used to promote moisture control and retraction of the gingival tissues. The aim of the present clinical trial was to evaluate the effects of two isolation techniques on the clinical performance of Class V restorations, as well on the periodontal conditions of restored sites. Patients presenting at least two noncarious cervical lesions (NCLs) were enrolled in this study. The NCLs were randomized into the following groups: (1) isolation performed with rubber dam and gingival retraction clamp and (2) isolation provided with cotton rolls and gingival retraction cord. Both techniques were used with a saliva suction device. All restorative procedures were performed using a selfetching adhesive system and a nanofilled composite resin according to the manufacturer s instructions. The clinical performance of restorations was recorded in terms of fracture and retention of restoration, marginal adaptation, marginal staining, postoperative hypersensitivity, and preservation of tooth vitality at 1 week and 6 months after placement.The periodontal condition of restored sites was evaluated based on the presence of supragingival plaque, gingival marginal bleeding, probing depth, and relative gingival recession. Thirty patients were enrolled in the study, yielding a total of 136 restorations (68 restorations per group). At the 6-month followup, one restoration from the rubber dam group and three restorations from the cotton roll group lost retention. In this period, the highest incidence of small marginal defects was observed in the group isolated with cotton rolls (p= 0.01). Both groups showed a statistically significant increase in supragingival plaque at six months after restoration placement (p< 0.05). However, no significant differences were detected among the two groups tested with respect to any of the criteria used to evaluate the restorations or the periodontal condition (p> 0.05). Within the limits of this study, it can be concluded that both isolation techniques resulted in equally clinically acceptable restorations without producing negative effects on periodontal tissues / Durante os procedimentos restauradores, diferentes métodos de isolamento do campo operatório podem ser utilizados a fim de promover controle de umidade e retração de tecidos gengivais. O objetivo do presente ensaio clinico foi avaliar os efeitos de duas técnicas de isolamento no desempenho clínico de restaurações Classe V, bem como na condição periodontal dos sítios restaurados. Pacientes apresentando, no mínimo, duas lesões cervicais não cariosas (LCNCs) foram selecionados para este estudo. As LCNCs foram randomizadas nos seguintes grupos: (1) isolamento com lençol de borracha e grampo retrator de gengiva e (2) isolamento com rolos de algodão e fio retrator de gengiva. Um sugador de saliva foi utilizado em ambas as técnicas. Todos os procedimentos restauradores foram executados com sistema adesivo autocondicionante e compósito restaurador nanoparticulado, seguindo as instruções dos fabricantes. O desempenho clinico das restaurações foi avaliado em termos de fratura e retenção da restauração, adaptação marginal, manchamento marginal, sensibilidade pós-operatória e preservação da vitalidade pulpar após 1 semana e 6 meses da inserção das restaurações.A condição periodontal dos sítios restaurados foi avaliada com base na presença de placa supragengival, sangramento gengival marginal, profundidade de sondagem e recessão gengival relativa. Trinta pacientes foram incluídos no estudo, resultando num total de 136 restaurações (68 restaurações por grupo). Após seis meses de acompanhamento, uma restauração do grupo isolado com lençol de borracha e três restaurações do grupo isolado com rolos de algodão perderam a retenção. Neste período, uma maior incidência de pequenos defeitos marginais foi observada no grupo que recebeu isolamento com rolos de algodão (p= 0.01). Ambos os grupos apresentaram um aumento significativo do acúmulo de placa supragengival após 6 meses da inserção das restaurações (p< 0.05). Porém, não foram detectadas diferenças estatisticamente significativas entre os dois grupos testados considerando os critérios utilizados para avaliação das restaurações e da condição periodontal (p> 0.05). Dentro das limitações deste estudo, foi possível concluir que ambas as técnicas de isolamento resultaram em restaurações clinicamente aceitáveis, sem produzir efeitos negativos nos tecidos periodontais

Objectifs : L’objectif principal de la recherche était d’évaluer les méthodes de traitements des lésions carieuses interproximales et occlusales chez l’enfant et l’adolescent par les dentistes canadiens afin de voir si ceux-ci se conforment aux nouvelles recommandations internationales sur la gestion de la carie dentaire. Pour ce faire, nous avons évalué le stade carieux auquel un dentiste décide de réaliser une restauration, la technique de restauration utilisée ainsi que le matériau choisi. L’objectif secondaire était d’évaluer s’il y a une différence entre les traitements réalisés par les dentistes selon différentes données socio-démographiques comme leur province de pratique, leur université de graduation, leur année de graduation et leur degré de spécialisation. Une comparaison a aussi été faite en analysant leur âge, leur sexe et leur fréquence de traitement chez une population pédiatrique. Méthode : Un questionnaire électronique a été créé sur le serveur protégé REDCap puis envoyé par courriel aux dentistes membres de différents ordres de réglementation provinciales canadiennes. Ce questionnaire comportait 11 questions portant d’abord sur les facteurs démographiques du répondant. Le dentiste répondant était ensuite exposé à 3 mises en situation cliniques sur la carie dentaire chez l’enfant et l’adolescent. Résultats : Sept-cent deux questionnaires soumis ont été inclus dans l’analyse statistique. 442 dentistes (62,6%) ont répondu traiter par ablation puis restauration une carie interproximale limitée à l’émail sur une molaire permanente. 502 dentistes (70,9%) des dentistes ont répondu faire de même pour une molaire primaire. Pour les lésions occlusales, ces chiffres sont de 300 dentistes (43,2%) pour une molaire permanente et de 269 dentistes (38,4%) pour une molaire primaire. La majorité des dentistes ont choisi des techniques de restauration plus conservatrices telles que la préparation en boite pour les dents permanentes (58,3%) et la résine composite comme matériau de restauration. L’âge, le sexe, l’année de graduation et la province de pratique ou de graduation sont des facteurs démographiques qui semblent avoir un impact sur les décisions des dentistes. Conclusion : Les résultats montrent que plusieurs des dentistes canadiens répondants traiteraient les lésions carieuses, en particulier les lésions interproximales, de manière plus agressive que les nouvelles recommandations. Par conséquent, cette étude montre qu'il existe des obstacles à l'intégration de nouvelles recommandations sur les techniques non chirurgicales pour le traitement de la carie dentaire. / Objectives: The main objective of the research was to assess the management of interproximal and occlusal caries in children and adolescents by Canadian dentists to assess compliance with the new international recommendations on dental caries management. To do this, the restorative threshold, the restoration techniques materials were evaluated. The secondary objective was to assess whether there was a difference between the treatments performed by dentists according to different sociodemographic data, such as their province of practice, their graduation year and University, and their degree of specialization. A comparison was also made analyzing their age, their gender and their frequency of treatment in a pediatric population. Method: An electronic survey was created with REDCap protected server and was sent by email to members of various Canadian provincial regulatory bodies. This survey included 11 questions on the demographic factors of the respondent. The responding dentist was then exposed to 3 clinical situations on dental caries in children and adolescents. Results: Seven hundred and two completed surveys were included in the statistical analysis. For interproximal carious lesions limited to the enamel, 442 (62.6%) responded treating by surgical removal for a permanent molar and 502 (70.9%) responded doing the same for a primary tooth. For occlusal carious lesions, those numbers were 300 dentists (43.2%) for a permanent molar and 269 dentists (38.4%) for a primary molar. The majority of dentists used conservative techniques such as a box-slot preparation for permanent teeth (58.3%) and restored primary and permanent molars with composite resin. The age, year of graduation, gender, province of graduation and of practice appear to have a statistically significant impact on the restorative threshold. Conclusion: Results show that many of the responding Canadian dentists would treat carious lesions, particularly interproximal lesions, more aggressively than the new recommendations for management of dental caries.