Objective This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment.Material and Methods Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning.Results Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal–Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05).Conclusions This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

Objective:Considering the minimally invasive approach to dentistry, the scientific community has focused on non-invasive treatments for caries lesions. The aim of this study was to evaluate the efficacy of a nonsurgical approach to arrest occlusal non-cavitated dentin lesions through glass ionomer sealing.Methods:In this controlled clinical trial, 51 teeth with clinically non-cavitated occlusal caries radiographically located beneath the enamel-dentine junction (radiolucent area) were selected among patients presenting a moderate to high risk of caries. The teeth were randomly divided into two groups: an experimental group receiving an application of Vidrion-R (SS White) glass ionomer and a control group not submitted to any clinical intervention. Caries progression was monitored by clinical and radiographic examination at 4-monthly intervals over a period of one year. In addition, marginal integrity of the sealant was evaluated in the experimental group.Results:Clinical examination showed no statistical difference between the groups (P=.13). On the other hand, sealed teeth presented lower caries progression when analyzed by radiographic examination (P=.004).Conclusion:A glass ionomer sealant over non-cavitated occlusal caries lesions in dentin may not be sufficiently effective in arresting their progression.

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Background:Dental whitening has been increasingly sought out to improve dental aesthetics, but may cause chemical and morphological changes in dental enamel surfaces.Objective:This study evaluated in vitro the effect of 10% strontium chloride and 5% potassium nitrate with fluoride on bovine enamel, through tristimulus colorimetry, Knoop microhardness (KHN), and roughness after bleaching with 35% hydrogen peroxide (HP).Methods:The specimens were divided into three groups (n=15): GControl received bleaching treatment with 35% HP; GNitrate received bleaching with 35% HP followed by the application of 5% potassium nitrate with 2% sodium fluoride; and GStrontium received bleaching with 35% HP followed by the application of 10% strontium chloride on the enamel. Next, five specimens of each experimental group were subjected to KHN and tristimulus colorimetry tests, and 10 specimens were subjected to surface roughness (SR) tests. The values obtained for the different groups were compared through analysis of variance (ANOVA) followed by a post-hoc Tukey-Kramer test in addition to Student’s T-test for paired data.Results:In the intergroup comparison, KHN final differed statistically (p<0.05). The mean SR final of the experimental groups differed statistically from the GControl group (p<0.05). In addition, the groups did not differ in color variation (p>0.05).Conclusion:10% strontium chloride and 5% potassium nitrate combined with 2% fluoride downplayed morphological changes to the enamel, without interfering with the effectiveness of the bleaching process.

Ao Senhor Jesus Cristo, pois sem Ele, nada disso seria possível. Aos meus pais, Roberto Campos Sales da Silveira e Jane Silva da Silveira, meu muito obrigado pelo apoio e incentivo constantes e sempre presentes na minha vida. A minha família, no papel do meu noivo, Clauber Figueiredo Martins, meus irmãos, Ana Beatriz Silva da Silveira e Roberto Campos Sales da Silveira Segundo, e a minha avó, Rita Silva da Silveira, pelo cuidado e carinho que me deram o suporte de que tanto precisei. A minha orientadora, Profª Drª Maria Aparecida Alves de Cerqueira Luz, agradeço pela excelente orientação, pelo suporte sempre presente, mesmo a distância, e por saber quando estar ao meu lado e quando soltar a minha mão. Com a senhora eu aprendi como ser uma orientadora melhor para os meus muitos orientados que virão. Obrigada! A coordenação do Doutorado Interinstitucional, nas pessoas das professoras Drª Cecy Martins Silva e Drª Miriam Lacalle Turbino, por fazerem tudo isto possível. A professora Drª Márcia Martins Marques por todas as orientações brilhantes, pela paciência e pela presença sempre que precisei. Ao professor Dr. Cesar Angelo Lascala, pelas orientações, pela disponibilidade e dedicação. Serei sempre grata! Ao professor Dr. Claudio Costa pelas considerações feitas a este estudo, pelo empréstimo do laboratório e pelo treinamento intensivo para o uso do software DIGORA ®. Ao professor Helder Henrique Costa Pinheiro pelo suporte estatístico tão essencial. A todos os professores da Faculdade de Odontologia da USP que participaram do DINTER, por todos os conhecimentos repassados. Aos amigos e colegas de turma do DINTER, pela caminhada juntos. A Universidade Federal do Pará e ao Instituto de Ciências da Saúde desta instituição pela concessão da minha licença para conclusão da tese.