Academic literature on the topic 'Non-carious lesions of teeth'

Introduction. A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. Objective. The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH), as well as their possible risk factors in children, in the population of the city of Novi Sad. Methods. A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE) index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. Results. The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (?2=3.86, df=1, p=0.04). The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65%) and canine permanent teeth (51%). BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36%) did not respond to air stimulus, while most patients with permanent teeth (74.29%) did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. Conclusion. Research has shown that despite the lack of subjective symptoms, these lesions have distinct clinical characteristics. The fact that they occur even in deciduous dentition justifies the need for further investigations.

Objective: To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). Methodology: It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1st January 2009 to 28th Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square X2 test was applied to assess association among different categorical variables. Result: Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value <0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Conclusion: Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant.

<strong><em>Introduction: </em></strong><em>Non-Carious&nbsp;<strong>Cervical Lesion</strong>&nbsp;(NCCL) is the loss of hard tooth tissue at the cement-enamel junction not caused by caries and it was categorized in V-shape and saucer-shape according to the shape of the lesion on the plat surface. </em> <strong><em>Objectives of the study: </em></strong><em>The main objective of the study is to analyze the different </em><em>risk factors associated with non-carious cervical lesions. </em> <strong><em>Material and methods: </em></strong><em>This cross sectional study was conducted in </em><em>RHC Sandhilianwali, Toba Tek Singh during February 2018 to November 2018. The data were collected through a questionnaire. The questionnaire included was administered to purposive consecutive sampling of patients that came to the dental OPD. The questionnaire included basic patient demographic information (name, age, gender and locality). The patients were asked if they felt sensitivity after blowing air from triple syringe, any aesthetic issues associated with the lesions. </em> <strong><em>Results: </em></strong><em>The number of lesions per patient ranged from 1-18, with 77% of them having 1-6 lesions. Almost all NCCLs were found on the buccal surface (99%). In this study, 73.4% of the NCCLs were on posterior teeth and 26.6% on anterior teeth, and 55.6% were on maxillary teeth and 44.4% on mandibular teeth, 55.6% were on right teeth and 44.4% on left teeth. First premolars (32.3%) and second premolars (22%) were affected often, followed by first molars (18.7%) and canines (10.2%). </em> <strong><em>Conclusion: </em></strong><em>It is concluded that </em><em>para functional habits were significantly associated with NCCLs and premolars were the most affected teeth.</em>

The high prevalence of non-carious manifestations in patients with celiac disease is described by numerous authors, who are considered as a diagnostic key to atypical forms of celiac disease. The manifestations closely associated with celiac disease include: defects in tooth enamel, pathological tooth abrasion, as a violation of the mineralization of dental crowns, and morphofunctional defects in the hard tissues of the teeth.Materials and methods. We examined 45 patients aged 23 to 36 years with a diagnosis of celiac disease, established on the basis of the results of clinical anamnestic, genetic, instrumental studies, morphological study of a biopsy specimen of the intestinal mucosa.Result. Examination of the dentition of the patients showed that 100% of the examined had pathological abrasion of tooth enamel. Crowded teeth were found in 32 patients. Partial symmetric congenital adentia was diagnosed in 5 patients.Conclusion. The revealed dentoalveolar anomalies can be attributed to oral manifestations of celiac disease, which is a diagnostic criterion for suspected disease.

Background: Dental caries is one of the most prevalent diseases. Its detection and management should start with a comprehensive treatment plan, with the goals of the elimination of cariogenic bacteria, the reduction of plaque acidogenicity, the encouragement of tooth remineralization, and the repair of damaged teeth. Objectives: The aim of this paper was to review the literature regarding the latest updates on the diagnosis and management approaches of non-cavitated carious dental lesions. Methods: Studies regarding the diagnosis and management of non-cavitated carious dental lesions were included. Results: The subclinical non-cavitated carious lesion might progress to an early enamel lesion, develop into an established dentin lesion, or sometimes end up with a lesion reaching the pulp. The detection and management of caries should be patient-centered, risk-based, and evidence-supported, and should consider the dentists’ expertise and the patients’ needs and preferences. The visual-tactile and radiographic detection of non-cavitated carious lesions are greatly helped by the advances of non-invasive detection tools such as DIAGNOdent, fiber-optic transillumination, quantitative light-induced fluorescence, and DIAGNOcam. Conclusion: Accordingly, non-cavitated carious lesions can be arrested by several non-invasive techniques, which are preferred over the invasive options. The clinicians can use sealants plus fluoride varnish on occlusal surfaces, fluoride varnish or resin infiltration on proximal surfaces, and resin infiltration,fluoride gel, or varnish alone on facial or lingual surfaces to manage non-cavitated carious lesions.

Bacground/Aim. Environmental lead (Pb) pollution is a global problem. Hard dental tissue is capable of accumulating lead and other hard metals from the environment. The aim of this study was to investigate any correlation between the concentration of lead in teeth extracted from inhabitants of Pancevo and Belgrade, Serbia, belonging to different age groups and occurrence of tooth loss, caries and non-carious lesions. Methods. A total of 160 volunteers were chosen consecutively from Pancevo (the experimental group) and Belgrade (the control group) and divided into 5 age subgroups of 32 subjects each. Clinical examination consisted of caries and hard dental tissue diagnostics. The Decayed Missing Filled Teeth (DMFT) Index and Significant Caries Index were calculated. Extracted teeth were freed of any organic residue by UV digestion and subjected to voltammetric analysis for the content of lead. Results. The average DMFT scores in Pancevo (20.41) were higher than in Belgrade (16.52); in the patients aged 31-40 and 41-50 years the difference was significant (p &lt; 0.05) and highly significant in the patients aged 51-60 (23.69 vs 18.5, p &lt; 0.01). Non-carious lesions were diagnosed in 71 (44%) patients from Pancevo and 39 (24%) patients from Belgrade. The concentrations of Pb in extracted teeth in all the groups from Pancevo were statistically significantly (p &lt; 0.05) higher than in all the groups from Belgrade. In the patients from Pancevo correlations between Pb concentration in extracted teeth and the number of extracted teeth, the number of carious lesions and the number of non-carious lesions showed a statistical significance (p &lt; 0.001, p &lt; 0.01 and p &lt; 0.001, respectively). Conclusion. According to correlations between lead concentration and the number of extracted teeth, number of carious lesions and non-carious lesions found in the patients living in Pancevo, one possible cause of tooth loss and hard dental tissue damage could be a long-term environmental exposure to lead.

Background and Objectives: The therapeutic management of carious lesions remains a significant focus for researchers, given their persistently high prevalence despite being largely preventable. This study aimed to compare the effectiveness of a composite resin-based sealant material in halting extended non-cavitated dentin carious lesions when used therapeutically versus preventively on caries-free teeth over a period of twelve months. Materials and Methods: out of the 236 children examined, 45 were excluded from the study due to non-compliance with the inclusion criteria. Thus, the study included 191 children aged 10–12 years, and 764 molars in total. Results: among these molars, 171 were caries-free (ICDAS II code 0), forming the Control group, while 180 molars were classified with an ICDAS II score of 3, forming the Study group. All molars were sealed and evaluated at 6- and 12-month follow-up intervals. Both intervals revealed statistically significant differences (p &lt; 0.05) in sealant retention and carious lesion development between sound (ICDAS code 0) and decayed (ICDAS code 3) teeth. Conclusions: the findings did not support the effectiveness of sealants in halting non-cavitated dentin carious lesions classified as ICDAS II with code 3 compared to their preventive application in sound teeth classified as ICDAS II with code 0.

Introduction: Non-carious lesions are caused as a result of tooth surface loss. Several categories of tooth surface loss exist, including erosion, attrition, abrasion and abfraction. Numerous factors, such as bruxism, clenching, disease, dietary considerations, lifestyle choices, improper tooth brushing, abrasive dentrifices, craniofacial complex, iatrogenic dentistry and ageing might contribute to this problem. It can be challenging to identify the cause, but it is feasible by observing the pattern of tooth surface loss on the teeth, and it is essential for treatment planning to avoid failure. Prevention, tooth remineralization and active treatment by repairing the affected teeth are all methods of managing this process. Treatment options include minimally invasive and adhesive dentistry to full mouth rehabilitation, and restoring the lost vertical height. Case Report: A 45-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with a chief complaint of sensitivity in the upper front teeth for the past 2 months. The clinical examination showed abrasion on the buccal surface of teeth 13 and 23 with dentin exposure. And also, abfraction with respect to 14. No signs of mobility or pain on percussion. Conclusion: The steps of problem identification, diagnosis, etiological factor removal or treatment, and, if necessary, restoration, are components of treating non-caries lesions. The restorative treatment must be considered for dentin hypersensitivity and for the re-establishing of dental esthetics.

The worldwide incidence of ECC was found to be 1.76 billion. If left untreated, these carious lesions have high possibility to progress into oro-facial swellings. The purpose of this study was to evaluate the carious teeth in primary dentition, which causes oro-facial swelling. This observational study is carried out by observing the oro-facial infection in children and describing the associated carious teeth using GV Black's classification, ICDAS Criteria for carious teeth and also categorizing the caries index of the patient using dmft index. A total of 189 case sheets were reviewed, and cross-verification was done by photographs. Among the 189 case sheets, a total of 70 cases were selected after proper review. Out of 70 patients, 51 patients had Class 1 carious lesion, and 19 had Class 2 carious lesion all the teeth were categorized under ICDAS score 5 and 6, the mean dmft score was 8.64. Class 1 carious lesions with visible dentin were most commonly associated with Oro-facial Swelling in children. The carious teeth, which were ICDAS-6, were treated by extraction and which were ICDAS-5, were rendered pulp therapy.

Background: Carious lesions are the record frequent oral health problem among school going kids everywhere the world. In the deciduous teeth, dental caries is the tenth most communal oral problem that affects about nine percent of the population worldwide. Aim: To report impact on quality of life of exposed carious lesion as reason for tooth extraction in 7-16 years children. Study design: Descriptive cross-sectional study. Place and duration of study: Sardar Begum Dental College and Peshawar Dental College, Peshawar from 1st January 2021 to 31st December 2021. Methodology: Three hundred and eight children aged 7-16 years of both genders were enrolled from two dental teaching hospitals of Peshawar. Children were examined clinically at a dental chair. A radiograph advised by the clinician was used to diagnose number of teeth having exposed carious lesions that are causing pain or extracted/filled because of pain were recorded for each participant in a structured data collection sheet. Child oral health impact short form was used to record oral health related quality of children. Results: There were 182(59.1%) males and 126(40.9%) females and mean age was 10.0±2.8 years. The correlation between OHRQoL and number of teeth with exposed carious lesions that are causing pain, filled or have been extracted because of pain is 0.610, which indicates positive correlation, as lesion increases the QoL of an individual will decrease. Conclusion: The positive correlations between OHRQoL and number of teeth having had exposed carious lesions that are causing pain, filled or have been extracted because of pain. It also signifies the negative impact of exposed carious lesion, over oral health related quality of life of 7-16 years old, visiting two tertiary care hospitals of Peshawar. Key words: Quality of life (QoL), Oral health related quality of life (OHRQoL), Peshawar

Mature dendritic cells (DCs) in inflamed tissues may promote inflammation but the status of DCs in pulpitis is not known. We hypothesized that DC maturation would correlate with carious lesion depth and that CD4+ cells would be found in association with mature DCs. Pulps were collected from teeth exhibiting: (I) no caries (n=9), (II) shallow dentinal caries (n=5), and (III) deep caries (n=9). Pulpal tissues were cryo-sectioned and positive cells were examined with immunohistochemistry, Mature DCs (CD83+) were almost exclusively restricted to pulps from deep caries. Furthermore, CD209+ DCs in deep caries were elevated over other groups and CD209+ cells about doubled the CD83+ cells suggesting that immature DCs had accumulated and were available for terminal maturation. CD4+ cells were found associated with both mature DCs and macrophages in pulps from deep caries suggesting that T cells may be a source of pro-inflammatory cytokines at this inflamed site. This document was created in Microsoft Word 2000.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico<br>Early childhood caries (ECC) is considered a serious public health issue among children all over the world. However, many aspects should be explored about the oral microbiota related to the ECC progression and how the bacterial community modifies according to the dentine lesion activity. This thesis, composed by two chapters, aimed to investigate and quantify with quantitative polymerase chain reaction (qPCR) the following bacteria Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, as well as members of the groups Lactobacillus casei and Mitis on biofilm from pre-school children with different stages of early childhood caries progression (Chapter 1) and on active and inactive dentine carious lesions (Chapter 2), and also to verify the association of these microorganisms on the process of health or disease. The sample consisted on preschool children aged between 2 and 5 years from nurseries and public preeschools in Fortaleza-CE. The children were examined for caries diagnosis with ICDAS II index (International Caries Detection Assessment System), and the Nyvad criteria, in order to evaluate prevalence and caries activity. The supragingival biofilm collection was taken from 75 children, who were divided in three groups according to the ICDAS II: CF (caries free) (n=20), ECL (presence of enamel caries lesion) (n=17) and DCL (presence of dentine caries lesion) (n=38). Samples of carious dentine were collected under rubber dam isolation of 56 lesions of dentine affected by caries, being 17 inactive and 39 active. The DNA of all the collected samples was extracted and purified, then tested for the presence of the formerly mentioned bacterial species/groups through qPCR. The quantity of bacteria was compared through the Kruskal-Wallis and Mann-Whitney tests. Besides, the association between the presence of bacteria and ECC was analyzed through the Chi-square test, with a 5% significance level and the multiple logistic regression was applied. Bacteria from the group L. casei and L. acidophilus presented low detection on biofilm of all evaluated groups. The presence of S. mutans and Bifidobacterium spp. showed a strong association with dental caries progression on the biofilm from children with dentine lesions with odds ratio of 21,5 and 5,9; respectively. On active dentine lesions, concentrations of Bifidobacterium spp. and species from the Lactobacillus casei group were significantly higher when compared to the inactive lesions (p<0.05). The levels of Actinomyces naeslundii, Streptococcus gordonni and species from Mitis group were not significantly different among biofilm groups as well as comparing dentine lesions. In conclusion, the microbial profile from biofilm samples presented differences on the proportion of acidogenic and aciduric bacteria with dental caries progression. The presence of Bifidobacterium spp. and S. mutans presented a strong association with the development of the more advanced stages of ECC. Regarding the activity of dentine lesions, higher detection levels of the group L. casei and Bifidobacterium spp. showed an important role of these bacteria in the dentine caries activity.<br>A cÃrie precoce da infÃncia (CPI) Ã considerada um grave problema de saÃde pÃblica em crianÃas prÃ-escolares em todo mundo. No entanto, muitos aspectos ainda devem ser explorados acerca da microbiota oral relacionada com a progressÃo da CPI e como a comunidade bacteriana se modifica de acordo com a atividade da lesÃo dentinÃria. Esta tese, constituÃda de dois capÃtulos, teve como objetivo identificar e quantificar atravÃs da tÃcnica de reaÃÃo em cadeia da polimerase quantitativa (qPCR) as bactÃrias Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, bem como espÃcies dos grupos Lactobacillus casei e Mitis em biofilme de crianÃas prÃ-escolares com diferentes estÃgios de progressÃo da cÃrie precoce da infÃncia (CapÃtulo 1) e em lesÃes cariosas dentinÃrias ativas e inativas (CapÃtulo 2) e ainda verificar a associaÃÃo destes microrganismos ao processo de saÃde ou de doenÃa. A amostra consistiu em prÃ-escolares com idade entre 2 e 5 anos de idade que frequentavam creches e escolas pÃblicas de Fortaleza-CE. As crianÃas foram examinadas com o uso de Ãndices visuais ICDAS II (International Caries Detection Assessment System) e Nyvad, a fim de avaliar a prevalÃncia e atividade de cÃrie. A coleta de biofilme supragengival foi realizada em 75 crianÃas, as quais foram agrupadas de acordo com Ãndice ICDAS II em trÃs grupos: CF (livres de cÃrie) (n=20), ECL (presenÃa de lesÃes de cÃrie em esmalte) (n=17) e DCL (presenÃa de lesÃes de cÃrie em dentina) (n=38). Amostras de dentina cariada foram coletadas sob isolamento absoluto de 56 lesÃes cariosas dentinÃrias, sendo 17 inativas e 39 ativas. O DNA de todas as amostras coletadas foi extraÃdo e purificado e, em seguida, testado para a presenÃa das espÃcies/grupos bacterianos acima citados atravÃs de qPCR. A quantidade das bactÃrias foi comparada pelos testes Kruskal-Wallis e Mann-Whitney. AlÃm disso, a associaÃÃo da presenÃa de bactÃrias e CPI foi analisada atravÃs do teste Qui-quadrado, com nÃvel de significÃncia de 5% e aplicado a regressÃo logÃstica mÃltipla. BactÃrias L. acidophilus e do grupo L. casei apresentaram baixa detecÃÃo no biofilme de todos os grupos avaliados. A presenÃa de S. mutans e Bifidobacterium spp. mostrou forte associaÃÃo com a progressÃo da doenÃa no biofilme de crianÃas com lesÃes dentinÃrias com âodds ratioâ de 21,5 e 5,9, respectivamente. Em lesÃes dentinÃrias ativas, concentraÃÃes de Bifidobacterium spp. e bactÃrias do grupo L. casei foram significativamente maiores quando comparadas Ãs lesÃes inativas (p<0.05). Os nÃveis de A. naeslundii, bactÃrias do grupo Mitis e S. gordonni nÃo apresentaram diferenÃa significativa entre os grupos de biofilme, assim como nas lesÃes dentinÃrias. Conclui-se que as amostras de biofilme apresentaram alteraÃÃo na proporÃÃo de bactÃrias acidogÃnicas e acidÃricas com a progressÃo da doenÃa cÃrie. A presenÃa de Bifidobacterium spp. e S. mutans apresentou forte associaÃÃo com os estÃgios mais avanÃados da CPI. Em relaÃÃo Ãs lesÃes dentinÃrias, o aumento da concentraÃÃo de bactÃrias Bifidobacterium spp. e do grupo L. casei evidenciou um papel importante destas bactÃrias na atividade de lesÃes dentinÃrias.

Thesis (M.S.)--University of Florida, 2004.<br>Typescript. Title from title page of source document. Document formatted into pages; contains 34 pages. Includes Vita. Includes bibliographical references.

Diante das mudanças no estilo de vida no mundo moderno e do envelhecimento da população mundial, um aumento na ocorrência de lesões cervicais não-cariosas vem ocorrendo. Como consequência, destaca-se a hipersensibilidade dentinária cervical, queixa comum entre os adultos e que representa um dos problemas mais críticos e persistentes em Odontologia. Este estudo clínico randomizado, longitudinal teve como objetivo avaliar diferentes protocolos de tratamento para hipersensibilidade dentinária com laser de baixa potência (com diferentes dosagens), laser de alta potência, agente dessensibilizante e associações, por um período de 06 meses. Após a análise dos padrões de inclusão e exclusão dos voluntários participantes do estudo, foram selecionados aqueles que apresentaram dor consequente de lesões cervicais não-cariosas. As lesões foram divididas em nove grupos (n=10), totalizando 90 dentes tratados e avaliados: G1: Gluma Desensitizer (Heraeus Kulzer), G2: Laser de baixa potência com baixa dosagem (Photon Lase, DMC, três pontos de irradiação vestibulares e um ponto apical: 30 mW, 10 J/cm2, 9 segundos por ponto com o comprimento de onda de 810nm. Foram realizadas três sessões com um intervalo de 72 horas), G3: Laser de baixa potência com alta dosagem (aplicação em um ponto cervical e um ponto apical: 100 mW, 90 J/cm2, 11 segundos por ponto com o comprimento de onda de 810nm. Foram realizadas três sessões com um intervalo de 72 horas entre as irradiações), G4: Laser de baixa potência com baixa dosagem + Gluma Desensitizer, G5: Laser de baixa potência com alta dosagem + Gluma Desensitizer, G6: Laser de Nd:YAG (Power LaserTM ST6, Lares Research®, em contato com a superfície dental: 1,0W, 10 Hz e 100 mJ, 85 J/cm2, com o comprimento de onda de 1064nm. Foram realizadas quatro irradiações de 15 segundos cada nos sentidos mesio - distal e ocluso - apical, totalizando uma irradiação de 60 segundos com intervalos de 10 segundos entre as irradiações), G7: Laser de Nd:YAG + Gluma Desensitizer, G8: Laser de Nd:YAG + Laser de baixa potência com baixa dosagem, G9: Laser de Nd:YAG + Laser de baixa potência com alta dosagem. O nível de sensibilidade de cada voluntário foi avaliado através da escala visual analógica de dor (VAS) com auxílio do ar da seringa tríplice e exploração com sonda após 5 minutos, 1 semana, 1, 3 e 6 meses do tratamento. Os dados foram coletados e submetidos à análise estatística que detectou diferenças estatisticamente significativas entre os tempos estudados (p<0,05). A partir da diferença de dor, observou-se que para ambos os estímulos, o protocolo com agente dessensibilizante Gluma Desensitizer e o Laser de Nd:YAG apresentaram efeitos imediatos de redução de dor, a partir do primeiro momento de sua aplicação e irradiação, respectivamente. Para os lasers de baixa potência, observou-se que os efeitos de diferentes dosagens foram distintos, porém ambos foram eficientes em reduzir a dor até os 6 meses de acompanhamento clínico. Após este período, observou-se que o protocolo com maior redução e menor aumento de dor ao longo do tempo foi a combinação do Gluma Desensitizer com o laser de Nd:YAG. Desse modo, pode-se concluir que todos os protocolos dessensibilizantes foram eficazes em reduzir a hipersensibilidade dentinária, porém com efeitos diferentes. A combinação de protocolos é uma alternativa interessante no tratamento da hipersensibilidade dentinária cervical.<br>Due to changes in lifestyle in the modern world and the world\'s population becoming older, an increase in the occurrence of non-carious cervical lesions is increasing. As a result, dentin hypersensitivity can be highlighted as a common complaint among adults and represents one of the most critical and persistent problems in dentistry. So, this randomized longitudinal clinical study aimed to assess different treatment protocols for dentinal hypersensitivity with low power laser (with different dosages), high-power laser, desensitizing agent and its associations, for a period up to 06 months. After the analysis of inclusion and exclusion criteria, volunteers were selected by those who presented pain consequent of non-carious cervical lesions. Lesions were divided into nine groups (n=10), totalizing 90 treat and evaluated teeth: G1: Gluma Desensitizer (Heraeus Kulzer), G2: Low Level Laser with low dosage (Photon Lase, DMC, irradiations on three cervical vestibular points and an apical point: 30mW, 10J/cm2, 9 seconds per point, with the wavelength of 810nm, in three sessions with 72 hours intervals), G3: Low Level Laser with high dosage (one cervical point and an apical point application: 100 mW, 90 J/cm2, 11 seconds by point, with the wavelength of 810nm. Three sessions were performed with 72 hours interval), G4: Low Level Laser with low dosage + Gluma Desensitizer, G5: Low Level Laser with high dosage + Gluma Desensitizer, G6: Nd:YAG Laser (Power LaserTM ST6, Lares Research®, in contact made with the protocol of 1.0 W, 10 Hz and 100 mJ, 85 J/cm2, with the wavelength of 1064nm. Four irradiations were performed, each for 15 seconds, in mesio-distal and ocluso-apical directions, totaling an irradiation of 60 seconds with 10 seconds intervals), G7: Nd:YAG Laser + Gluma Desensitizer, G8: Nd:YAG Laser + Low Level Laser with low dosage, G9: Nd:YAG Laser + Low Level Laser with high dosage. The sensitivity level of each volunteer was analyzed by visual analog scale (VAS) with the aid of cold air stimuli and exploration probe in 5 minutes, 1 week, 1, 3 and 6 months after treatment. Data were collected and subjected to statistical analysis that detected statistically significant differences between the various times of studied (p<0,05). It was observed that for air stimuli, the protocol with Gluma Desensitizer and the Nd:YAG laser presented immediate effect of pain reduction, from the first moment of its application and irradiation, respectively. For low power lasers, it was observed that the effect of different dosages had been distinct; however both were efficient in reducing pain within 6 months of clinical follow-up. After this period, it was observed that the protocol with highest reduction of pain and minor increase throughout the time was the combination of the Gluma Desensitizer with the Nd:YAG laser. In conclusion, all protocols were effective in reducing dentinal hypersensitivity; however with different effects. The combination of treatments is also an interesting option for reducing dentin hypersensitivity.

A realização de preparos cavitários que removam menor quantidade de substrato dentário sadio, oferecendo maior conforto e menor sensibilidade durante o tratamento odontológico em crianças, associado ao emprego de materiais restauradores estéticos adesivos são procedimentos comumente empregados na odontologia minimamente invasiva. O presente estudo tem por objetivo avaliar a sensibilidade dentária durante a remoção seletiva das lesões de cárie e preparo cavitário em dentes decíduos e o método de remoção de tecido cariado preferido pelas crianças. Foram selecionadas 20 crianças entre 7 e 10 anos, apresentando pelo menos duas lesões de cárie ativas, com cavitação atingindo dentina localizadas na superfície oclusal de molares decíduos homólogos. Os dentes de cada criança foram distribuídos aleatoriamente em dois grupos: (I) Laser de Er:YAG (250mJ / 4 Hz), para remoção do esmalte cavo superficial e remoção seletiva da lesão de cárie associado a curetas e (II) Método Convencional (turbina de alta rotação para remoção do esmalte cavo-superficial e turbina de baixa rotação para a remoção seletiva do tecido cariado associado a curetas). A sensibilidade dentária foi analisada durante a remoção seletiva de lesões de cárie e preparo cavitário, empregando a escala facial analógica. A preferência pelo método de remoção de tecido cariado pelas crianças foi avaliado após 7 dias da realização das restaurações. Nas cavidades médias foi realizada proteção pulpar indireta com cimento de ionômero de vidro (Ketac Molar - 3M), nas cavidades profundas foi realizada proteção pulpar indireta utilizando cimento de hidróxido de cálcio (Dycal - Dentisply) e cimento de ionômero de vidro (Ketac Molar - 3M). Todas as cavidades preparadas foram restauradas empregando o sistema restaurador Adper Single Bond 2 / Filtek Supreme (3M). Os dados obtidos relativos à sensibilidade dentária foram submetidos ao teste de Fischer e os resultados não indicaram associação entre os tratamentos realizados e a face indicada pela criança (p=0,065), na escala facial analógica. Em relação à preferência pelo método de remoção seletiva de lesões de cárie, 90% das crianças optaram pela utilização do laser de Er:YAG. Considerando a metodologia utilizada e os resultados obtidos pode-se concluir que independente do método utilizado, convencional ou laser de Er:YAG, a sensibilidade dentária não foi alterada durante a remoção seletiva de lesões de cárie, no entanto o laser foi o método preferido pela grande maioria das crianças.<br>Cavity preparations removing fewer sound dental substrates, providing greater comfort and less sensitivity during the dental treatment in children, associated to the use of adhesive esthetic restorative materials are procedures usually employed in minimally invasive dentistry. The present study aimed to evaluate the tooth sensitivity during the selective carious lesions removal and cavity preparation in primary teeth and the preference by the method employed to remove the carious tissue. Twenty children aged between 7-10 year, who presented at least two active carious lesions with cavitation reaching dentine, located on the occlusal surface of homologous primary molars, were selected. The teeth of each child was randomly assigned to one of these groups: (I) Er:YAG laser (250mJ/ 4 Hz) to remove the cavosurface enamel and selective carious lesion removal associated with curettes, and (II) Conventional Method (high speed turbine to remove the cavosurface enamel and low speed turbine to selective carious tissue removal associated with curettes). The tooth sensitivity was assessed during the selective carious tissue removal and cavity preparation, using an analog facial scale, and the preference by the method of selective removal of carious tissue was evaluated 7 days after the tooth restoration. At cavities with medium depth, an indirect pulp capping was performed with glassionomer cement (Ketac Molar - 3M) and at deep cavities, the indirect pulp capping was performed with calcium hydroxide cement (Dycal - Dentsply) plus glass-ionomer cement (Ketac Molar - 3M). All of them were restored using the restorative system Adper Single Bond 2 / Filtek Supreme (3M). The data related to the tooth sensitivity were subjected to Fischers test and the results indicated no association between the experimental treatments and the face indicated by the child (p=0,065) at the analog facial scale. Regarding the preference by the method of selective carious tissue removal, 90% of the children chose the employ of Er:YAG laser. It can be concluded that the Er:YAG laser had no influence at tooth sensitivity during the selective carious lesions removal at primary teeth, however, it was the preferred method by children.

OBJETIVO: A etiologia das LNCs é complexa e não está totalmente esclarecida e parecem influir e interagir na sua formação fatores tão diversos como a concentração de tensões, a presença de ácidos de diversas origens e mecanismos tribológicos variados. O objetivo deste estudo in vitro foi avaliar se há diferenças na influência da tensão de tração, de compressão e da escovação na profundidade da lesão, microdureza e rugosidade do esmalte bovino submetido a desafio ácido. (O trabalho constituiu-se da avaliação dos danos ao esmalte bovino submetido a um desafio ácido erosivo e desafio abrasivo) com carregamento mecânico simultâneo. MÉTODOS: Foram avaliados 48 palitos contendo esmalte e dentina, com dimensões de (2,7 x 2,7 x 16 mm). O esmalte dos palitos foi planificado com lixas de granulação 600 e 800 e depois posteriormente polidos com lixas de granulação 1000, 1200, 2400 e 4000. Foi confeccionado um entalhe transversal de 1,5 mm de diâmetro na dentina, deixando um \"pescoço\" de 1,7 mm de esmalte e dentina. Toda a superfície do palito, exceto uma janela de 4 mm na vestibular do esmalte (na região de maior concentração de tensão), recebeu uma camada que protegia frente ao desafio ácido. Os palitos foram fixados em uma de suas extremidades e divididos em 2 grupos (n=24): submetidos a uma carga contínua (650 gf) à flexão na outra extremidade (sendo que 12 deles com o entalhe voltado para cima compressão e 12 com o entalhe para baixo tração) e outro grupo de palitos descarregados (n=24). Com esta divisão, todos os palitos sofreram o primeiro desafio ácido (2 horas em 400 ml de solução de ácido cítrico tamponado, ajustado ao pH 3,75, a 37° C) e, a seguir, foram mensurados (degrau e rugosidade com o perfilômetro, além de microdureza). Depois, cada grupo foi subdividido em dois com igual número (n=6 para os carregados, e n=12 para os sem carregamento): um grupo recebeu escovação com dentifrício e outro com água, foram novamente protegidos e foram expostos ao segundo desafio ácido (com ou sem carregamento). Após nova medição (degrau e rugosidade com o perfilômetro, além de microdureza) e re-proteção, foram submetidos ao terceiro desafio ácido e novamente mensurados. Um grupo extra de 24 palitos foi destinado à avaliação por microscopia de luz polarizada, dividido em três subgrupos (n=8): sem carga, submetidos à tração e submetidos à compressão e desafio ácido por 2 horas. RESULTADOS: em todos os estágios houve aumento na profundidade da lesão (dependendo do grupo, variou de 1,9 m no primeiro estágio a 7,9 m no último a 4,5 m no primeiro estágio a 19,2 m no último). A tensão de tração produziu profundidade de lesão (segundo estágio: 16,2 m; último estágio: 19,2 m) significativamente maior que a de compressão (segundo estágio: 9,2 m; último estágio: 13,4 m) apenas do lado fixado no grupo de espécimes escovados com dentifrício. A rugosidade foi maior na área exposta (Ra variando de 0,36 a 0,55) que na protegida (Ra variando de 0,13 a 0,28), mas nenhuma das tensões influiu significativamente em nenhuma das duas. Em todos os casos constatou-se diminuição significativa da rugosidade no segundo estágio (da ordem de 0,8 unidades de Ra para áreas protegidas e 0,16 para as expostas), atribuível à escovação, tanto com dentifrício quanto com água. A tensão não provocou diferenças significantes na microdureza em nenhum dos grupos, mas a escovação com dentifrício, no segundo estágio, produziu microdureza significativamente maior, tanto nas áreas protegidas (410 KNH) quanto nas expostas (140 KNH) quando comparadas com os respectivos primeiros estágios (318 KHN e 60 KHN, respectivamente). CONCLUSÃO: o efeito da tensão sobre a profundidade da lesão depende da presença de outros fatores, pois nos espécimes escovados com água, a tensão não provocou efeito estatisticamente significante na profundidade da lesão, nem do lado do entalhe nem do lado fixado. Apenas nos palitos escovados com dentifrício e do lado da fixação foi possível constatar aumento significante da profundidade da lesão (no segundo e terceiro estágios) da tração em relação à compressão, sendo que os sem tensão tiveram profundidade intermediária. A tensão de tração levou ao aparecimento de micro-trincas detectáveis pela microscopia de luz polarizada. Já em relação à microdureza, a tensão não provocou diferenças significantes em nenhum caso, mas apenas a escovação com dentifrício pode ser responsabilizada por aumento da dureza. A rugosidade na área exposta foi bem maior que na protegida, mas a tensão não influiu significativamente. A escovação (com água ou com dentifrício) diminuiu a rugosidade no segundo estágio. No segundo estágio, a rugosidade diminui nas áreas expostas e protegidas e a microdureza aumenta nos grupos escovados com dentifrício nas áreas expostas e protegidas.<br>OBJECTIVE: The etiology of LNC\'s is complex and not fully understood and seem to influence and interact in their formation diverse factors as stress concentration, the presence of acids of various origins and various tribological mechanisms. The purpose of this in vitro study was to evaluate whether there are differences in the influence of tensile stress, compression stress and brushing on the lesions depth, hardness and roughness of bovine enamel subjected to acid challenge. The work consisted of assessing damage to bovine enamel subjected to an erosive acid challenge (and abrasive) with simultaneous mechanical loading. METHODS: The work consisted of assessing the mineral loss in enamel subjected to an erosive acid challenge and biomechanical loading. We evaluated 48 sticks containing enamel and dentin, with dimensions (2.7 x 2.7 x 16 mm). These sticks were planned with sandpapers with granulation 600 and 800 and after subsequently polished with sandpaper granulation 1000, 1200, 2400 and 4000. A transverse notch of 1,5 mm diameter was made on dentin leaving a neck of 1,7mm of enamel and dentin. The entire surface of the specimen, except for a window of 4 mm on the buccal enamel (the region of highest stress concentration), received a protection against the acid challenge. The specimens were fixed at one end and divided into two groups (n = 24): subjected to a continuous bending load (650 gf) applied to the other end (where 12 of them were fixed with the notch facing up - compression - and 12 with the notch down - tensile) and another group of specimens unloaded (n = 24). With this division, all specimens suffered the first acid challenge (2 hours in 400 ml of buffered citric acid solution, adjusted to pH 3.75 at 37 ° C) and, then, were measured (lesion depth and surface roughness with profilometer, and also micro hardness). Then each group was subdivided into two with the same number (n = 6 for loaded ones and n=12 for unloaded ones): A group received brushing with toothpaste and other just with water, then they were protected again and exposed to the second acid challenge (with load or without load). After remeasurement (lesion depth and roughness with profilometer, and micro hardness) and re-protection, the specimens were subjected to the third acid challenge and again measured. An extra set of 24 sticks was used for the evaluation by polarized light microscopy, divided into three subgroups (n = 8) without load, subjected to tension and under compression. RESULTS: In all stages the lesion depth have increased:(depending of the group, ranged from 1.9 m in the first stage to 7.9 m in the last stage and 4.5 m in the first stage to 19.2 m in the last stage). The tensile stress produced lesion depth (second stage: 16.2 mm; last stage: 19.2 mm) significantly higher than the compression (the second stage: 9.2 mm; last stage: 13.4 mm) only in the fixed side in the group of specimens brushed with toothpaste. The roughness was higher in the exposed area (Ra ranging from 0.36 to 0.55) than in the protected one (Ra varying from 0.13 to 0.28), but the stress was not significantly correlated in either. In all cases it was observed a significant reduction in roughness in the second stage (about 0.8 units of Ra for the protected areas to 0.16 for the exposed), attributable to brushing with toothpaste as well with water. The stress did not cause significant differences in the micro hardness in either group, but brushing with toothpaste, in the second stage, produced significantly higher micro hardness in, both areas, protected areas (410 KNH) and the exposed (140 KNH) when compared with their early stages (318 KHN and 60 KHN, respectively). CONCLUSION: The effect of stress on the lesion depth depends of the presence of other factors; therefore the specimens brushed with water, the stress caused no statistically significant effect on lesion depth neither in the fixed nor in the notch side. Just in the specimens brushed with toothpaste in the side of fixation was possible to observe a significant increase of the lesion depth (in the second and third stages) of the tensile stress in relation to the compression, whereas the specimens not submitted to stress presented intermediate lesion depth values. The tensile stress led to the emergence of micro-cracks detectable by polarized light microscopy. Regarding to the micro hardness, the stress did not cause significant differences in any case but only brushing with toothpaste may be responsible for increased hardness. The roughness in the exposed area was much higher than in the protected, but the stress was not significantly correlated. Brushing with water or toothpaste reduces the roughness in the second stage for the specimens brushed with toothpaste. In the second stage, the roughness decreases in the exposed and protected areas and the micro hardness increases in the groups brushed with toothpaste in the exposed and protected areas.

107f.<br>Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-04-24T13:22:41Z No. of bitstreams: 2 Diss-Marta Muhana2.pdf: 1637273 bytes, checksum: ac65c9c450ae3aebd90e9f6f6ec3c6e4 (MD5) Diss-Marta Muhana1.pdf: 165760 bytes, checksum: 87e83b0d5357d040a370c0b33f16b476 (MD5)<br>Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-05-08T11:47:25Z (GMT) No. of bitstreams: 2 Diss-Marta Muhana2.pdf: 1637273 bytes, checksum: ac65c9c450ae3aebd90e9f6f6ec3c6e4 (MD5) Diss-Marta Muhana1.pdf: 165760 bytes, checksum: 87e83b0d5357d040a370c0b33f16b476 (MD5)<br>Made available in DSpace on 2013-05-08T11:47:25Z (GMT). No. of bitstreams: 2 Diss-Marta Muhana2.pdf: 1637273 bytes, checksum: ac65c9c450ae3aebd90e9f6f6ec3c6e4 (MD5) Diss-Marta Muhana1.pdf: 165760 bytes, checksum: 87e83b0d5357d040a370c0b33f16b476 (MD5) Previous issue date: 2005<br>O presente trabalho avaliou a distribuição de tensões em dentes com Lesões Cervicais não Cariosas (LCNC) desenvolvidas in vivo, por meio do Método de Elementos Finitos (MEF), empregando o programa Ansys 7.1. Este estudo, foi realizado por meio da construção de 10 modelos bidimensionais (2D) representativos de pré-molares humanos, com LCNC pré-existentes desenvolvidas in vivo, submetidos à carga de 45N na vertente interna da face vestibular, num ângulo de 45° em relação ao longo eixo do dente. A amostra foi constituída de 4 dentes superiores e 6 inferiores que se apresentaram com duas configurações geométricas distintas: lesões em forma de cunha (n=4) e lesões arredondadas (n=6); três tipos de base: voltada para oclusal (n= 3), para cervical (n= 5) e padrão misto ou indefinido (n= 2) e com duas formas de término cervical: ângulo vivo (n= 3) e arredondado (n= 7). As tensões foram analisadas pelo critério de von Mises a partir de pontos de leitura padronizados e simbolizados por letras, traçados em três linhas ? Linha Externa (LE), Linha Média (LM) e Linha Interna (LI) ? nas áreas da lesões. A escala de 25 cores, do programa Ansys, que expressa, de forma qualitativa, os diferentes valores da e, foi exportada para o programa Adolbe photoshop para elaboração de tabela de dados, resultante da analogia entre a concentração de pigmentos RGB: Vermelho (Red ? R), Verde (Green ? G) e azul (Blue) e a escala mencionada acima. Os valores constantes dessa tabela viabilizaram a equivalência, de modo objetivo e preciso, das cores dos pontos determinados nas LE, LM e LI com a escala de cor, representativa da e. Esse procedimento permitiu a elaboração de uma planilha com o objetivo de inserir os gráficos para facilitar a interpretação dos dados. Os resultados demonstraram que a distribuição de tensão variou principalmente na dependência da forma da lesão, isto é, quanto mais aguda a lesão, maior a concentração de tensão. Também se constatou que a maior intensidade de concentração de tensão ocorreu no vértice de todas as lesões. Baseado nestes resultados conclui-se que a forma geométrica da LCNC influencia a distribuição de tensões e determina a magnitude e a severidade da concentração de tensão na área da lesão.<br>Salvador

A saúde oral proporciona equilíbrio que interfere diretamente na saúde geral e psicológica. É importante que o dentista faça avaliação detalhada dos esportistas, detectando alterações e patologias que possam comprometer o desempenho durante treinos e/ou competições. As LCNCs apresentam etiologia multifatorial e são caracterizadas pela perda de estrutura dental na região de junção cemento-esmalte (região cervical), não relacionadas à presença de cárie, sendo comumente encontradas na rotina clínica odontológica. A perda de estrutura dental provocado pela presença das LCNCs pode levar a exposição dos túbulos dentinarios, possibilitando o aparecimento da HD. Essa dissertação teve como objetivos principais avaliar a prevalência de LCNCs e HD em atletas profissionais (GA) e a presença de fatores de risco associados ao estilo de vida de atletas. Após autorização do CEP, avaliou-se 264 atletas profissionais com no mínimo 17 anos e que realizavam treinamento mínimo de 10 hrs/semana, e 195 indivíduos no grupo controle. Aplicou-se questionário com tópicos como: dieta, DTM e parafunção. No exame clínico avaliou-se fatores oclusais, periodontais, presença de LCNC e HD. chave). Alguns dos resultados encontrados foram: a média de idade dos atletas foi de 20,33 anos, e do controle 23,75. O GC apresentou maioria do gênero feminino (61,54%, p<0,001), enquanto que o GA foi predominância masculina (90,46%). Os atletas consomem mais isotônicos (26,52%, p<0,001), refrigerantes (68,56%, p=0,010) e suplementos (38,64%, p<0,001) do que o GC. A prevalência de biocorrosão foi de 28,03% no GA e 15,38% no GC. Os incisivos inferiores (25,75%) foram os dentes mais afetados com HD, e os pré-molares com LCNC no GA. Os atletas apresentaram maior número de ausências de pelo menos um dente (21,21%, p<0,001) quando comparadas ao grupo controle. O GA apresentou mais alteração em sua mordida (47,43%, p<0,001) do que o GC. Dentro das limitações do nosso estudo, conclui-se que: a prevalência de LCNC e de HD em atletas foram de 17,42% e 35,25% respectivamente; a prevalência de LCNC e HD no grupo controle foi de 18,97% e 48,20% respectivamente; os atletas apresentaram diversos fatores de risco para o desenvolvimento das alterações, sendo eles: ingestão de isotônicos, refrigerantes e suplementos; presença elevada de placa bacteriana; maior ausência de elementos dentários; alteração maxilo-mandibular, ausência de guia canina e escovação imediata após ingestão de alimentação acida.<br>The oral health provides balance that directly affects the general and psychological health. It is important that the dentist make detailed evaluation of athletes, detecting changes and conditions that may compromise performance during training and / or competition. The LCNCs have multifactorial etiology and is characterized by loss of tooth structure in the cementum-enamel junction region (neck), unrelated to the presence of caries, it is commonly found in dental practice routine. The loss of tooth structure caused by the presence of LCNCs can lead to exposure of dentinal tubules, allowing the appearance of the HD. Thus, this thesis has as main objectives to assess the prevalence of LCNCs and HD professional athletes (GA), to assess the prevalence of LCNCs and HD in the control group (CG). After approval of the CEP, we evaluated 264 professional athletes with at least 17 years and performed minimal training 10 hrs / week and 195 individuals in the control group. applied questionnaire with topics such as diet, DTM and parafunction. On examination it evaluated occlusal, periodontal factors, presence of LCNC and HD. Some of the results were: the average age of the athletes was 20.33 years, and control 23,75. GC showed most females (61.54%, p<0,001), while the GA was predominantly male (90.46%). Athletes consume more isotonic (26.52%, p<0,001), soft drinks (68.56%, p=0,010) and supplements (38.64%, p<0,001) than the GC. The prevalence of biocorrosion was 28.03% in GA and 15.38% in the control group. The lower incisors (25.75%) were the teeth most affected by HD, and the pre molars with LCNC in GA. The athletes had higher number of absences of at least one tooth (21.21%, p<0,001) compared to the control group. The GA had more change in your bite (47.43%, p<0,001) than the GC. Within the limitations of our study, it is concluded that: the prevalence of LCNC and HD athletes were 17.42% and 35.25% respectively. The prevalence of LCNC and HD in the control group was 18.97% and 48.20% respectively. Athletes had several risk factors for the development of changes, namely: isotonic intake, soft drinks and supplements; high presence of plaque; greater absence of teeth; maxillo-mandibular change, absence of canine guidance and immediate brushing after food intake acidic.

Carious lesions can range from early, non-detectable mineral loss, restricted to enamel, through to lesions that extend into dentine without any surface cavitation, to cavitated lesions, which destroy the tooth tissue and can be visible as cavities in the teeth. Cavitated caries lesions generally are non-cleansable and thus active; therefore, these lesions most commonly need to be restored. Selective removal of carious tissues is guided by the depth of the lesion, pulpal health, and choice of dental material. Fluoride is the cornerstone of the non-invasive management of non-cavitated caries lesions. Still, its ability to promote net remineralisation is limited by the availability of calcium and phosphate ions. Ideal remineralisation material should diffuse or deliver calcium and phosphate into the subsurface lesion or boost the remineralisation properties of saliva and oral reservoirs without increasing the risk of calculus formation. These options are often no longer feasible for carious lesions where the tooth tissue surface has become cavitated, as the biofilm is sheltered and cannot be easily removed or manipulated. In such situations, invasive (restorative) options are required. With the advent of adhesive restorations and facilitated by the described changing understanding of the pathogenesis of caries and carious lesions, a paradigm shift in restorative dentistry occurred. In asymptomatic, vital teeth with deep lesions, conservative carious tissue removal strategy,s that reduce tissue loss and pulp exposure risk must be balanced against removing adequate tissue to maximise restoration longevity. In two stages, the most recent inspiration for stepwise carious removal originates from the knowhow on Intra lesion changes in deep carious lesions. Natural enamel and dentin are still the best “dental materials” in existence; therefore, minimally invasive procedures that conserve a more significant part of the wild, healthy tooth structure must be considered desirable. Ultraconservative dentistry represents a significant step forward for the dentist, the profession, and especially the patient. A changing understanding of the disease of dental caries has initiated a paradigm shift in the management of carious lesions. Instead of merely removing the symptoms of the carious lesion, any treatment aims to manage the disease.

Modern dentistry aims at preserving the tooth structure in a non- invasive manner. The transition from G V black’s “extension for prevention” to minimal intervention methods paved path for diagnosis of caries during the initial stages of demineralization. Initial caries lesion otherwise called as “white spot lesion” is a subsurface enamel demineralization occurring on the smooth surface of the teeth. “White spot lesion” – coined by FEJERSKOV et al. as – “the first sign of carious lesion that is visible to naked eye”. The white or chalky appearance of the white spot lesion is due to the difference in the scattering of light over the demineralized enamel. Apart from pre-disposing factors like microorganisms, diet and host factors, long term deposition of “undisturbed” plaque helps in the initiation of white spot lesion. These initial carious lesions appear after 4 weeks of demineralization The superficial layer of the enamel remains intact due to the protective action of the salivary proteins, Statherin. Since these salivary proteins are macromolecules, they will not penetrate into the subsurface layer of the enamel and thus its protective action remains confined to the superficial layers. Due to the continuous diffusion of acids, there will be decalcification in the subsurface layer of the enamel. The shape of the white spot lesion depends on the dissemination of the biofilm and enamel prism’s direction. Patients with fixed orthodontic appliance are prone for white spot lesions because of the difficulty in removal of plaque and more areas of “undisturbed” plaque retention. After the removal of appliance, remineralization of the lesion occurs, resulting in hard and shiny appearance of the surface area making the subsurface lesion less visible.

Despite innovations in orthopedic dentistry, removable dentures belong to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Trauma or traumatic injuries to the teeth can cause necrosis of the pulp by disrupting blood supply leading to anaerobic conditions which favors growth of opportunistic micro organisms, which over time may subsequently result in development of periapical lesions The patient had a large periapical lesion in the anterior region of the mandible with mobile teeth. After stabilization by splinting, non surgical treatment was done. During the non surgical RCT, after access opening yellow straw coloured uid was aspirated through the root canal, cleaning and shaping was the done followed by placement of Calcium hydroxide for 2 weeks interval for a month, followed by placement of TAP for another 2 appointments at 2 weeks interval for a month. Satisfactory periapical healing was seen at 1 month, 2month and 5 month recall, with considerable decrease in size of the lesion and decrease in mobility with the teeth. ABSTRACT KEYWORDS : Healing, Nonsurgical, Periapical lesion, Aspiration, Cyst, Triple antibiotic paste, Calcium