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Puetate CFS, Girotto AC, Zaniboni JF, Gelio MB, Besegato JF, Kuga MC. Sealing of pulp chamber dentin in endodontics: Influence of bond strategy and time-point application. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:514-519. [PMID: 38939549 PMCID: PMC11205169 DOI: 10.4103/jcde.jcde_80_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 06/29/2024]
Abstract
Context Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward. Aims The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability. Materials and Methods Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images. Statistical Analysis Used Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (α = 0.05). Results IES-CF showed the lowest dentinal penetrability (P < 0.05), while the other protocols were similar to each other (P > 0.05). No significant differences were found between groups regarding the hybrid layer formation (P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used. Conclusions Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy.
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Affiliation(s)
| | - Aline Carvalho Girotto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Sao Paulo, Brazil
| | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Sao Paulo, Brazil
- School of Dentistry (FAODO), Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Sao Paulo, Brazil
| | - João Felipe Besegato
- School of Dentistry (FAODO), Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Sao Paulo, Brazil
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Zaniboni JF, de Souza V, Escalante-Otárola WG, Leandrin TP, Fernández Godoy E, Besegato JF, Kuga MC. Cleaning and microstructural effects of amyl acetate on pulp chamber dentin impregnated with epoxy resin-based endodontic sealer. J ESTHET RESTOR DENT 2022; 34:1282-1289. [PMID: 36161756 DOI: 10.1111/jerd.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the cleaning potential of 95% ethanol, acetone, and amyl acetate solutions used solely or in association, to remove epoxy resin-based sealer residues from pulp chamber dentin and their microstructural effects. MATERIALS AND METHODS One hundred and eighty bovine incisor specimens were divided into nine groups according to the cleaning protocol: ET (ethanol); AC (acetone); AA (amyl acetate); E1: AA+AC; E2: AA+ET; E3: AC+ET; E4: AA+AC+ET; PC (positive control), and NC (negative control). All groups were impregnated with epoxy resin-sealer, except NC. Ninety specimens were divided into groups (n = 10) for evaluation of persistence of residues and amount of open dentinal tubules by SEM analysis and evaluation of chemical compounds on the dentin surface after cleaning with electron dispersive spectroscopy. The others 90 specimens were submitted to Knoop microhardness evaluation. Persistence of residues data were submitted to the Kruskal Wallis and Dunn tests (α = 0.05). Open dentinal tubules and microhardness data were submitted to one-way ANOVA and Mann Whitney tests (α = 0.05). RESULTS AA and E4 protocols showed the lowest persistence of residues. E4 group had the highest incidence of open dentinal tubules. E3 and E4 groups showed no changes in the atomic ratio Ca/P, which was similar to NC group. E4 group did not present W, an element presents in all the other groups. ET and E4 protocols showed the smallest reduction in dentin microhardness. CONCLUSIONS The combination of amyl acetate, acetone and ethanol is the most effective and safe protocol to remove epoxy sealer residues on pulp chamber dentin. Moreover, it has the lowest microhardness reduction. CLINICAL SIGNIFICANCE The combined use of amyl acetate, acetone, and ethanol enhanced the cleaning of pulp chamber dentin with minimal microstructural damage.
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Affiliation(s)
- Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Brazil
| | - Vitor de Souza
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Brazil
| | | | - Thaís Piragine Leandrin
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Brazil
| | - Eduardo Fernández Godoy
- Department of Restorative Dentistry, Universidad de Chile, Santiago, Chile.,Instituto de Ciencias Biomédicas, Universidad Autonoma de Chile, Santiago, Chile
| | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Brazil
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Zaniboni JF, de Souza V, Escalante-Otárola WG, Porto TS, Godoy EF, Kuga MC. Impact of cleansing protocols to remove endodontic sealer residues on the adhesive interface: Bonding with universal adhesive systems. J ESTHET RESTOR DENT 2022; 34:1077-1084. [PMID: 35567506 DOI: 10.1111/jerd.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of cleansing protocols to remove sealer residues using different cleaning strategies and the effect of bond strength of two universal adhesives to dentin impregnated with epoxy resin-based sealer. MATERIALS AND METHODS Fifty bovine dentin specimens were impregnated with epoxy resin-based sealer containing calcium hydroxide (Sealer Plus) and submitted to cleansing protocols (n = 10): negative control (NC), positive control (PC), 95% ethanol (ET), xylol (XI), and amyl acetate (AA). Specimens were evaluated by scanning electron microscope (SEM). Other 100 specimens were submitted to the same protocols (n = 20). Each protocol was divided into subgroups (n = 10) according to the universal adhesive system used: Scotchbond Universal (SU); Ambar Universal (AU). Bond strength was evaluated by micro-shear bond test (μSBT). Persistence of residues data were assessed with Kruskal-Wallis and Dunn's tests. μSBT data were analyzed with two-way ANOVA (α = 5%). RESULTS ET presented higher persistence of residues compared to AA and XI (p < 0.05). AA and XI were similar from each other (p > 0.05). AU and SU presented similar μSBT values, regardless of the cleansing solution (p > 0.05). SU-NC presented the highest μSBT among all conditions (p < 0.05). CONCLUSION The bond strength of universal adhesives was not affected by different amounts of sealer residues after different cleaning protocols. CLINICAL SIGNIFICANCE Non-polar substances such as amyl acetate and xylol are effective for removing residues from epoxy resin-based endodontic sealers.
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Affiliation(s)
- Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry of Araraquara, São Paulo State University, Araraquara, SP, Brazil
| | - Vitor de Souza
- Department of Restorative Dentistry, School of Dentistry of Araraquara, São Paulo State University, Araraquara, SP, Brazil
| | | | - Thiago Soares Porto
- Department of Restorative Dentistry, School of Dentistry of Araraquara, São Paulo State University, Araraquara, SP, Brazil
| | - Eduardo Fernandez Godoy
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Providencia, Chile
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry of Araraquara, São Paulo State University, Araraquara, SP, Brazil
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Manzoli TM, Zaniboni JF, Besegato JF, Guiotti FA, Dantas AAR, Kuga MC. Bonding effects of cleaning protocols and time-point of acid etching on dentin impregnated with endodontic sealer. Restor Dent Endod 2022; 47:e21. [PMID: 35692228 PMCID: PMC9160758 DOI: 10.5395/rde.2022.47.e21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/21/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to investigate the bonding effects of cleaning protocols on dentin impregnated with endodontic sealer residues using ethanol (E) or xylol (X). The effects of dentin acid etching immediately (I) or 7 days (P) after cleaning were also evaluated. For bonding to dentin, universal adhesive (Scotchbond Universal; 3M ESPE) was used. The persistence of sealer residues, hybrid layer formation and microshear bond strength were the performed analysis. Materials and Methods One hundred and twenty bovine dentin specimens were allocated into 4 groups (n = 10): G1 (E+I); G2 (X+I); G3 (E+P); and G4 (X+P). The persistence of sealer residues was evaluated by SEM. Confocal laser scanning microscopy images were taken to measure the formed hybrid layer using the Image J program. For microshear bond strength, 4 resin composite cylinders were placed over the dentin after the cleaning protocols. ANOVA followed by Tukey test and Kruskal-Wallis followed by Dunn test were used for parametric and non-parametric data, respectively (α = 5%). Results G2 and G4 groups showed a lower persistence of residues (p < 0.05) and thicker hybrid layer than the other groups (p < 0.05). No bond strength differences among all groups were observed (p > 0.05). Conclusions Dentin cleaning using xylol, regardless of the time-point of acid etching, provided lower persistence of residues over the surface and thicker hybrid layer. However, the bond strength of the universal adhesive system in etch-and-rinse strategy was not influenced by the cleaning protocols or time-point of acid etching.
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Affiliation(s)
- Tatiane Miranda Manzoli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
| | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
| | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
| | - Flávia Angélica Guiotti
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
| | - Andréa Abi Rached Dantas
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University – UNESP, Araraquara, SP, Brazil
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Castro-Núnez GM, Dos Santos JREV, Zaniboni JF, Escalante-Otárola WG, Porto TS, Kuga MC. Effect of mechanical cleaning protocols in the fiber post space on the adhesive interface between universal adhesive and root dentin. Microsc Res Tech 2022; 85:2131-2139. [PMID: 35141981 DOI: 10.1002/jemt.24071] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/10/2022]
Abstract
The aim of this study was to evaluate the effects of cleaning protocols on the presence of residues, open dentinal tubules, and bond strength of a self-etch adhesive plus a dual-cure resin cement to dentin in the fiber-post space. The methods for cleaning utilized were conventional irrigation (CI), rotary brush with continuous rotary movement (RB), and continuous ultrasonic irrigation (CUI). Sixty bovine incisors were used for fiber-post space preparation. Thirty roots were divided into three groups (n = 10) according to the cleaning protocols and submitted to scanning electron microscope to evaluate presence of residues and relative quantity of open dentinal tubules on dentin surface. Similar protocols were performed in the other thirty roots (n = 10) using a self-etching adhesive system (Scotchbond Universal) and a dual-cure resin cement (Relyx Unicem 2). After 6 months cervical, middle, and apical thirds sections of fiber-post space were submitted to push-out testing. To data ANOVA and Tukey's test were employed (α = 5%). RB and CUI showed the lowest presence of residues on dentin surface (p = .015) and the highest bond strength values (p < .001), regardless of the dentin third. CUI presented the highest quantity of open dentinal tubules in middle and apical thirds (p < .001). CI presented the lowest bond strength value of resin cement, regardless of dentin third (p < .001). Mechanical cleaning protocols, such as RB and CUI, presented better surface cleaning capabilities and higher bond strength than CI with dual-cure resin cement employed. The use of a mechanical cleaning protocol seems to cause appropriate condition on the root dentin surface. Mechanical cleaning of root dentin provided greater bond strength of the self-etching system with dual resin cement. Conventional irrigation did not provide adequate root dentin cleaning.
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Affiliation(s)
| | | | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Thiago Soares Porto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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Zaniboni JF, Besegato JF, Guiotti FA, Vitória MS, Lima RO, Kuga MC. Hybrid layer formation and bond strength to dentin impregnated with endodontic sealer after cleaning protocols. J Conserv Dent 2021; 24:179-183. [PMID: 34759586 PMCID: PMC8562836 DOI: 10.4103/jcd.jcd_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/18/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
Aims: This study evaluated the hybrid layer formation and bond strength of two adhesive systems, Scotchbond Universal (U) or Adper Scotchbond Multi Purpose (M), after cleaning protocols using ethanol (E) or xylol (X), to dentin impregnated with an epoxy-resin based endodontic sealer. Settings and Design: The study design was an Experimental in vitro study. Methodology: One hundred bovine dentin specimens were randomly allocated into five groups (n = 10): Computed tomography (CT) (control): Only acid etching + M; E+U; X+U; E+M. After the specimen preparation, images were obtained using confocal laser scanning microscopy to evaluate the hybrid layer formation. For microshear bond strength test, the dentin specimens were included in polyvinyl chloride tubes and four resin composite cylinders were placed on the surface. The analysis was performed 24 h after storage. Statistical Analysis Used: For parametric and nonparametric data, analysis of variance followed by Tukey test and Kruskal–Wallis, followed by Dunn test were, respectively, used at a significance level of 5%. Results: Regarding hybrid layer formation, all experimental groups were similar to each other (P > 0.05). However, CT showed higher hybrid layer formation than other groups (P < 0.05), except in relation to X+M (P > 0.05). Bond strength was statistically similar among all groups (P > 0.05). Conclusions: Hybrid layer formation in dentin impregnated with epoxy resin-based sealer and submitted to different cleaning protocols was similar to the control group only for X+M. No differences were found among the experimental groups. Regarding the bond strength, no effect was observed for any group.
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Affiliation(s)
- Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Flávia Angelica Guiotti
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Matheus Sousa Vitória
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Reinaldo Oliveira Lima
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
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Girotto AC, Abuna G, Sanchez-Puetate C, Piccioni MA, Porto TS, Kuga MC. Effect of different adhesive strategies and storage time on bond strength of bifunctional monomers to simulated endodontically-treated dentin. Dent Mater J 2021; 40:1410-1417. [PMID: 34321370 DOI: 10.4012/dmj.2021-074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Adhesive strategies were evaluated on the bond strength of bi-functional monomers bonded to endodontically-treated-dentin (ETD). Superficial dentin was removed on human molars. Teeth were immersed in 5 mL 2.5% NaOCl, followed by immersion in 5 mL 17% EDTA. Dentin surface impregnated with epoxy resin-based sealer was then divided four groups (n=10): Scotchbond Multi-Purpose (SBMP); Single Bond Universal (SBU); Optibond All-in-One (OPB); and Tetric-N-Bond Universal (TBU). After 24-h or 1-year-of-storage specimens were submitted to microtensile bond strength (µTBS) and failure classification. A confocal laser scanning microscope (CLSM) evaluated the hybrid layer formation. Two-way ANOVA and Tukey-HSD test were performed (α=5%). The µTBS did not present statistical differences among adhesive strategies after 24-h. Significant differences were found after 1-year-of-storage. CLSM analysis showed water infiltration and consequently degradation of the hybrid layer after 1-year-of-storage. The use of SBU universal adhesive on the self-etching mode on ETD produced more stable bond over the 1-year-of-storage.
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Affiliation(s)
- Aline Carvalho Girotto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
| | - Gabriel Abuna
- Department of General Dentistry, School of Dental Medicine, East Carolina University
| | | | - Mayra Andressa Piccioni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
| | - Thiago Soares Porto
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
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Morais JMP, Victorino KR, Escalante-Otárola WG, Jordão-Basso KCF, Palma-Dibb RG, Kuga MC. Effect of the calcium silicate-based sealer removal protocols and time-point of acid etching on the dentin adhesive interface. Microsc Res Tech 2018; 81:914-920. [DOI: 10.1002/jemt.23056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/23/2018] [Accepted: 05/01/2018] [Indexed: 11/11/2022]
Affiliation(s)
| | - Keli Regina Victorino
- Department of Restorative Dentistry; Araraquara Dental School, Univ Estadual Paulista (UNESP); Araraquara Brazil
| | | | | | - Regina Guenka Palma-Dibb
- Department of Restorative Dentistry; Ribeirão Preto Dental School, São Paulo University (USP); Ribeirão Preto Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry; Araraquara Dental School, Univ Estadual Paulista (UNESP); Araraquara Brazil
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Galloza MO, Jordão-Basso KC, Bandeca MC, Costa SO, Borges AH, Tonetto MR, Tirintan FC, Keine KC, Kuga MC. Effects of the Ratio between Pigment and Bleaching Gel on the Fracture Resistance and Dentin Microhardness of endodontically treated Teeth. J Contemp Dent Pract 2017; 18:1051-1055. [PMID: 29109320 DOI: 10.5005/jp-journals-10024-2174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of bleaching gel using 35% hydrogen peroxide (HP), associated with red carmine pigment (RC), in the 3:1 or 1:1 ratio, on fracture resistance and dentin microhardness of endodontically treated teeth. MATERIALS AND METHODS A total of 40 lower incisors were endodontically treated and divided into four groups (n = 10), according to the bleaching protocol: G1 (HP3), 35% HP + RC (3:1); G2 (HP1), 35% HP + RC (1:1); G3 (positive), 38% HP; and G4 (negative), unbleached. Four dental bleaching sessions were performed. The dental crowns were restored after the last session and submitted to the fracture resistance test. Totally, 60 specimens from the endodontically treated lower incisor crowns were prepared to evaluate the effects on dentin microhardness. The analysis was measured (in Knoop) prior to and after the last dental bleaching session using similar bleaching protocols. RESULTS G2 presented the lowest fracture resistance (p < 0.05). The other groups were similar to each other (p > 0.05). No difference was observed in the reduction of dentin microhardness among the groups (p > 0.05). CONCLUSION A 1:1 ratio (bleaching gel:pigment) caused a significant fracture resistance reduction in relation to the other protocols. No effect on the dentin microhardness reduction was observed. CLINICAL SIGNIFICANCE The pigment addition to the bleaching agent accelerates the bleaching chemical reaction. However, no studies have evaluated the ideal proportion to optimize tooth bleaching.
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Affiliation(s)
| | | | - Matheus C Bandeca
- Department of Postgraduate in Dentistry, CEUMA University São Luís, Rua Jossue Montello, 01, São Luís, Maranhão, Brazil, e-mail:
| | - Samuel O Costa
- Department of Postgraduate in Dentistry, CEUMA University São Luís, Maranhão, Brazil
| | - Alvaro H Borges
- Department of Postgraduate Programme, Integrated Dental Sciences University of Cuiaba, Mato Grosso, Brazil
| | - Mateus R Tonetto
- Department of Postgraduate Programme, Integrated Dental Sciences University of Cuiaba, Mato Grosso, Brazil
| | - Fabio C Tirintan
- Department of Postgraduate Programme, Integrated Dental Sciences University of Cuiaba, Mato Grosso, Brazil
| | - Kátia C Keine
- Department of Dentistry, UNESP, Araraquara, São Paulo Brazil
| | - Milton C Kuga
- Department of Dentistry, UNESP, Araraquara, São Paulo Brazil
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