Objectives The purpose of the present study was to evaluate the effect of calcium hydroxide with 2% chlorhexidine gel (HCX) or distilled water (HCA) compared to triple antibiotic paste (TAP) on push-out bond strength and the cement/dentin interface in canals sealed with White MTA Angelus (WMTA) or Biodentine (BD). Materials and Methods A total of 70 extracted human lower premolars were endodontically prepared and randomly divided into 4 groups according to the intracanal medication, as follows: group 1, HCX; group 2, TAP; group 3, HCA; and group 4, control (without intracanal medication). After 7 days, the medications were removed and the cervical third of the specimens was sectioned into five 1-mm sections. The sections were then sealed with WMTA or BD as a reparative material. After 7 days in 100% humidity, a push-out bond strength test was performed. Elemental analysis was performed at the interface, using energy-dispersive spectroscopy. The data were statistically analyzed using analysis of variance and the Tukey test ( p < 0.05). Results BD presented a higher bond strength than WMTA ( p < 0.05). BD or WMTA in canals treated with calcium hydroxide intracanal medications had the highest bond strength values, with a statistically significant difference compared to TAP in the WMTA group ( p < 0.05). There were small amounts of phosphorus in samples exposed to triple antibiotic paste, regardless of the coronal sealing. Conclusions The use of intracanal medications did not affect the bond strength of WMTA and BD, except when TAP was used with WMTA.

This clinical case report describes a conservative approach to a smile harmony rehabilitation performing a gingivoplasty, dental bleaching and resin-based composites to finalize the case. This clinical article describes the case report of a patient in need of an esthetic and corrective solution for the anterior teeth, which presented a disharmonic smile, in its shape and color, besides the gingival smile. As a result, gingivoplasty, dental bleaching and restoration with composite resin were done. Gingivoplasty with bone preservation was possible because there was a large volume of soft tissue, and a distance ≥ 2 mm from the bone crest to the junction cementum enamel was confirmed. Bleaching was performed with the use of associated techniques: office (Whiteness HP 35%) and supervised at-home (Whiteness Perfect 10%) bleaching were performed, and then the "buccolingual technique" using a nanocomposite resin IPS was used from a diagnostic wax-up to perform the restorative procedure for the anterior teeth. The use of minimally invasive techniques is an effective alternative for the  anterior teeth rehabilitation. As in this case, the gingivoplasty, dental bleaching with associated techniques, and restorations with nanocomposites allowed satisfactory esthetic results, even more so in relation to dental preservation, mainly in young patients. Keywords: Tooth Bleaching. Gingivoplasty. Esthetic. Dental RestorationAbstractThis clinical case report describes a conservative approach to a smile harmony rehabilitation performing a gingivoplasty, dental bleaching and resin-based composites to finalize the case. This clinical article describes the case report of a patient in need of an esthetic and corrective solution for the anterior teeth, which presented a disharmonic smile, in its shape and color, besides the gingival smile. As a result, gingivoplasty, dental bleaching and restoration with composite resin were done. Gingivoplasty with bone preservation was possible because there was a large volume of soft tissue, and a distance ≥ 2 mm from the bone crest to the junction cementum enamel was confirmed. Bleaching was performed with the use of associated techniques: office (Whiteness HP 35%) and supervised at-home (Whiteness Perfect 10%) bleaching were performed, and then the "buccolingual technique" using a nanocomposite resin IPS was used from a diagnostic wax-up to perform the restorative procedure for the anterior teeth. The use of minimally invasive techniques is an effective alternative for the  anterior teeth rehabilitation. As in this case, the gingivoplasty, dental bleaching with associated techniques, and restorations with nanocomposites allowed satisfactory esthetic results, even more so in relation to dental preservation, mainly in young patients. Keywords: Tooth Bleaching. Gingivoplasty. Esthetic. Dental Restoration

Resumo O objetivo deste estudo foi avaliar in vitro o efeito de três medicações intracanais: hidróxido de cálcio P.A e clorexidina 2% gel (HCX), pasta tripla antibiótica-metronidazol 400mg, ciprofloxacina 250mg e minociclina 50mg (TAP) e hidróxido de cálcio P.A e água destilada (HCA) na resistência de união (push-out) do MTA Angelus branco® (M) e Biodentine® (B). Realizou-se o preparo químico-mecânico de 70 pré-molares inferiores humanos extraídos, divididos aleatoriamente em 7 grupos de acordo com a medicação intracanal e o material de selamento cervical utilizado: grupo A (HCX + M), grupo B (HCX + B), grupo C (TAP + M), grupo D (TAP + B), grupo E (HCA + M), grupo F (HCA + B) e Grupo G (grupo controle sem medicação intracanal). O terço cervical dos espécimes foi dividido em 5 amostras de 1mm cada e então foi realizado o teste de push-out em máquina de ensaio universal. A análise estatística foi realizada pelos procedimentos GENMOD do programa SAS 9.4. Os resultados mostraram que o Biodentine® obteve, significativamente, os maiores valores de resistência de união, independentemente do tipo de medicação intracanal utilizada. Todas as medicações intracanais diminuíram os valores de resistência de união nas amostras em que foi utilizado o MTA Angelus branco® (p<0,05) e aumentaram a resistência ao deslocamento nas amostras em que o Biodentine® foi usado, com exceção do grupo TAP (p<0,05). Concluiu-se que o Biodentine® apresenta maior resistência de união à dentina radicular que o MTA Angelus branco®, independente de qual medicação intracanal foi usada.

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