Use of resin-bonded extracoronal attachments with removable partial denture: case report

Introduction: Resin-bonded extracoronal attachments may be indicated for the abutment teeth of removable partial dentures, especially for anterior teeth when a cingulum rest must be provided. This type of treatment has a series of advantages such as minimal tooth reduction, supragingival margins, favourable stress distribution, and improved aesthetic appearance. Objective: To report a clinical case of oral rehabilitation using a combination of resin-bonded extracoronal attachments joined by a Dolder bar with a removable partial denture. Case report: A 60-year-old male patient with only the canines in the maxillary arch was restored with a combination of resin-bonded extracoronal attachments joined by a Dolder bar and a removable partial denture. Conclusion: Dentures with resin-bonded extracoronal attachments can have a number of advantages over traditional clasp-retained removable partial dentures.

Study of the surface hardness and modulus of elasticity of conventional and microwave-cured acrylic resins

The aim of this study was to evaluate the following acrylic resins: Clássico®, QC-20® and Lucitone®, recommended specifically for thermal polymerization, and Acron MC® and VIPI-WAVE®, made for polymerization by microwave energy. The resins were evaluated regarding their surface nanohardness and modulus of elasticity, while varying the polymerization time recommended by the manufacturer. They were also compared as to the presence of water absorbed by the samples. The technique used was nanoindentation, using the Nano Indenter XP®, MTS. According to an intra-group analysis, when using the polymerization time recommended by the manufacturer, a variation of 0.14 to 0.23 GPa for nanohardness and 2.61 to 3.73 GPa for modulus of elasticity was observed for the thermally polymerized resins. The variation for the resins made for polymerization by microwave energy was 0.15 to 0.22 GPa for nanohardness and 2.94 to 3.73 GPa for modulus of elasticity. The conclusion was that the Classico® resin presented higher nanohardness and higher modulus of elasticity values when compared to those of the same group, while Acron MC® presented the highest values for the same characteristics when compared to those of the same group. The water absorption evaluation showed that all the thermal polymerization resins, except for Lucitone®, presented significant nanohardness differences when submitted to dehydration or rehydration, while only Acron MC® presented no significant differences when submitted to a double polymerization time. Regarding the modulus of elasticity, it was observed that all the tested materials and products, except for Lucitone®, showed a significant increase in modulus of elasticity when submitted to a lack of hydration.

Temperature of denture base resin under different protocols of microwave irradiation

This in vitro study evaluated the temperature of dentures after different microwave irradiation protocols. Two complete dentures (one maxillary and one mandibular denture) were irradiated separately 4 times for each of the following 5 protocols: dentures immersed in water (G1- 6 min, G2- 3 min); dentures kept dry (G3- 6 min); dentures placed in the steam sterilizer (G4- 6 min, G5- 3 min). The final temperature of the dentures was gauged in a thin and in a thick area of each denture with an infrared thermometer. All groups presented an increase in the resin base temperature. The thin areas of the dentures underwent greater heating than the thick areas. There was no significant difference (p>0.05) between the final mean temperatures of dentures immersed in water for 6 (G1) and 3 min (G2). However, the final mean temperatures recorded in G1 and G2 exceeded 71°C and were significantly higher (<0.001) than the final mean temperatures recorded in the other groups. It may be concluded that denture base resins subjected to microwave irradiation immersed in water may be exposed to deleterious temperatures.

Differential bonds degradation of two resin-modified glass-ionomer cements in primary and permanent teeth

Objectives: To evaluate the effect of chemical degradation on bond strength of resin-modified glass-ionomer cements bonded to primary and permanent dentin. Methods: Class I cavities of permanent and primary extracted human molars were restored with two resin-modified glass-ionomer cements: Fuji 11 LC and Vitremer, and stored in water for 24 h. Half samples were immersed in 10% NaOCl aqueous solution for 5 h. Teeth were sectioned into beams and tested for microtensile bond strengths. Results were analyzed with multiple ANOVA and Tukey`s tests (p < 0.05). Analysis of debonded surfaces was performed by SEM. Results: 24 h bond strengths for Vitremer and Fuji 11 LC were similar. For Fuji 11, bond strength values were higher for primary than for permanent dentin. Vitremer bond strength was similar for both. Chemical degradation did not affect Fuji I] LC bond strength to dentin. However, decreases in bond strength were found for Vitremer groups after NaOCl immersion. Signs of glass ionomer-dentin interaction were evident by SEM analysis for Fuji 11 LC specimens. Conclusions: Vitremer and Fuji II presented similar bond strength at 24. Vitremer dentin bonds were prone to chemical degradation. Fuji II LC-dentin bonds showed typical features of glass-ionomer dentin interaction at the bonded interfaces, and were resistant to in vitro degradation. (C) 2009 Elsevier Ltd. All rights reserved.

Fracture resistance of endodontically treated teeth with different heights of crown ferrule restored with prefabricated carbon fiber post and composite resin core by intermittent loading

This study evaluated the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts and varying quantities of coronal dentin. Sixty freshly extracted upper canines were randomly divided into groups of 10 teeth each. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis. Data were analyzed by 1-way analysis of variance and Tukey test (alpha = .05). Significant differences (P < .001) were found among the mean fracture forces of the test groups (positive control, 0 mm, 1 mm, 2 mm, 3 mm, and negative control groups: 1022.82 N, 1008.22 N, 1292.52 N, 1289.19 N, 1255.38 N, and 1582.11, respectively). These results suggested that the amount of coronal dentin did not significantly increase the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber post and composite resin core. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e52-e57)

Influence of intraradicular post and crown ferrule on the fracture strength of endodontically treated teeth

The aim of this study was to investigate the fracture strength of endodontically treated teeth restored with different posts and variable ferrule heights. Sixty freshly extracted human canines were treated endodontically and randomly assigned to 6 groups (n=10), being restored with custom-made cast post-and-core (CP0 and CP3 groups), prefabricated post and composite resin core (PF0 and PF3 groups), and composite resin (CR0 and CR3 groups). The CP0, PF0 and CR0 groups presented no ferrule and the CP3, PF3 and CR3 presented 3 mm of coronal structure. All teeth were restored with full metal crowns. The fracture strength was measured in a universal testing machine at 45o to the long axis of the tooth until failure. Data were analyzed statistically by 2-way ANOVA and Tukey's test (?=0.05). When the mean fracture strength values were compared (CP0 group - 820.20 N, CP3 group - 1179.12 N; PF0 group - 561.05 N; PF3 group - 906.79 N; CR0 group - 297.84 N; and CR3 group - 1135.15 N) there was statistically significant among the groups (p<0.05), except for the three groups with 3 mm of coronal remaining, which were similar to each other. The results of this study showed that the ferrule in crowns promoted significantly higher fracture strength in the endodontically treated teeth.

Effect of different ferrule designs on the fracture resistance and failure pattern of endodontically treated teeth restored with fiber posts and all-ceramic crowns

OBJECTIVE: This study investigated the effect of different ferrule heights on endodontically treated premolars. MATERIAL AND METHODS: Fifty sound mandibular first premolars were endodontically treated and then restored with 7-mm fiber post (FRC Postec Plus #1 Ivoclar-Vivadent) luted with self-polymerized resin cement (Multilink, Ivoclar Vivadent) while the coronal section was restored with hybrid composite core build-up material (Tetric Ceram, Ivoclar-Vivadent), which received all-ceramic crown. Different ferrule heights were investigated: 1-mm circumferential ferrule without post and core (group 1 used as control), a circumferential 1-mm ferrule (group 2), non-uniform ferrule 2-mm buccally and 1-mm lingually (group 3), non-uniform ferrule 3-mm buccally and 2-mm lingually (group 4), and finally no ferrule preparation (group 5). The fracture load and failure pattern of the tested groups were investigated by applying axial load to the ceramic crowns (n=10). Data were analyzed statistically by one-way ANOVA and Tukey's post-hoc test was used for pair-wise comparisons (α=0.05). RESULTS: There were no significant differences among the failure load of all tested groups (P<0.780). The control group had the lowest fracture resistance (891.43±202.22 N) and the highest catastrophic failure rate (P<0.05). Compared to the control group, the use of fiber post reduced the percentage of catastrophic failure while increasing the ferrule height did not influence the fracture resistance of the restored specimens. CONCLUSIONS: Within the limitations of this study, increasing the ferrule length did not influence the fracture resistance of endodontically treated teeth restored with glass ceramic crowns. Insertion of a fiber post could reduce the percentage of catastrophic failure of these restorations under function.

Effect of different cleansers on the weight and ion release of removable partial denture: an in vitro study

OBJECTIVE: Removable partial dentures (RPD) require different hygiene care, and association of brushing and chemical cleansing is the most recommended to control biofilm formation. However, the effect of cleansers has not been evaluated in RPD metallic components. The aim of this study was to evaluate in vitro the effect of different denture cleansers on the weight and ion release of RPD. MATERIAL AND METHODS: Five specimens (12x3 mm metallic disc positioned in a 38x18x4 mm mould filled with resin), 7 cleanser agents [Periogard (PE), Cepacol (CE), Corega Tabs (CT), Medical Interporous (MI), Polident (PO), 0.05% sodium hypochlorite (NaOCl), and distilled water (DW) (control)] and 2 cobalt-chromium alloys [DeguDent (DD), and VeraPDI (VPDI)] were used for each experimental situation. One hundred and eighty immersions were performed and the weight was analyzed with a high precision analytic balance. Data were recorded before and after the immersions. The ion release was analyzed using mass spectrometry with inductively coupled plasma. Data were analyzed by two-way ANOVA and Tukey HSD post hoc test at 5% significance level. RESULTS: Statistical analysis showed that CT and MI had higher values of weight loss with higher change in VPDI alloy compared to DD. The solutions that caused more ion release were NaOCl and MI. CONCLUSIONS: It may be concluded that 0.05% NaOCl and Medical Interporous tablets are not suitable as auxiliary chemical solutions for RPD care.

Effect of different cleansers on the surface of removable partial denture

Removable partial dentures (RPD) demand specific hygienic cleaning and the combination of brushing with immersion in chemical solutions has been the most recommended method for control of biofilm. However, the effect of the cleansers on metallic components has not been widely investigated. This study evaluated the effect of different cleansers on the surface of RPD. Five disc specimens (12 mm x 3 mm metallic disc centered in a 38 x 18 x 4 mm mould filled with resin) were obtained for each experimental situation: 6 solutions [Periogard (PE), Cepacol (CE), Corega Tabs (CT), Medical Interporous (MI), Polident (PO), 0.05% sodium hypochlorite (NaOCl), and distilled water (DW) control] and 2 Co-Cr alloys [DeguDent (DD) and VeraPDI (VPDI)] were used for each experimental situation. A 180-day immersion was simulated and the measurements of roughness (Ra, µm) of metal and resin were analyzed using 2-way ANOVA and Tukey’s test. The surface changes and tarnishes were examined with a scanning electronic microscopy (SEM). In addition, energy dispersive x-ray spectrometry (EDS) analysis was carried out at representative areas. Visually, NaOCl and MI specimens presented surface tarnishes. The roughness of materials was not affected by the solutions (p>0.05). SEM images showed that NaOCl and MI provided surface changes. EDS analysis revealed the presence of oxygen for specimens in contact with both MI and NaOCl solutions, which might suggest that the two solutions promoted the oxidation of the surfaces, thus leading to spot corrosion. Within the limitations of this study, it may be concluded that the NaOCl and MI may not be suitable for cleaning of RPD.

Effect of ageing and immersion in different beverages on properties of denture lining materials

OBJECTIVES: To evaluate the color stability and hardness of two denture liners obtained by direct and indirect techniques, after thermal cycling and immersion in beverages that can cause staining of teeth. MATERIAL AND METHODS: Seventy disc-shaped specimens (18 x 3 mm) processed by direct (DT) and indirect techniques (IT) were made from Elite soft (n=35) and Kooliner (n=35) denture liners. For each material and technique, 10 specimens were subjected to thermal cycling (3,000 cycles) and 25 specimens were stored in water, coffee, tea, soda and red wine for 36 days. The values of color change, Shore A hardness (Elite soft) and Knoop hardness (Kooliner) were obtained. The data were subjected to ANOVA, Tukey's multiple-comparison test, and Kruskal-Wallis test (P<0.05). RESULTS: The thermal cycling promoted a decrease on hardness of Kooliner regardless of the technique used (Initial: 9.09± 1.61; Thermal cycling: 7.77± 1.47) and promoted an increase in the hardness in the DT for Elite Soft (Initial: 40.63± 1.07; Thermal cycling: 43.53± 1.03); hardness of Kooliner (DT: 8.76± 0.95; IT: 7.70± 1.62) and Elite Soft (DT: 42.75± 1.54; IT=39.30± 2.31) from the DT suffered an increase after the immersion in the beverages. The thermal cycling promoted color change only for Kooliner in the IT. Immersion in the beverages did not promote color change for Elite in both techniques. The control group of the DT of Kooliner showed a significant color change. Wine and coffee produced the greatest color change in the DT only for Elite Soft when compared to the other beverages. CONCLUSION: The three variation factors promoted alteration on hardness and color of the tested denture lining materials.

Influence of ferrule preparation with or without glass fiber post on fracture resistance of endodontically treated teeth

OBJECTIVE: This study evaluated the effect of ferrule preparation (Fp) on the fracture resistance of endodontically treated teeth, restored with composite resin cores with or without glass fiber posts. MATERIAL AND METHODS: Forty-four bovine teeth were sectioned 19 or 17 mm (2 mm ferrule) from the apex, endodontically treated and assigned to four groups (n = 11): Group 1: Fp and post; Group 2: Fp and without post; Group 3: without Fp and with post; Group 4: without Fp and without post. All specimens were restored with composite resin core and metal crown. Specimens were subjected to fracture resistance testing in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed by two-way ANOVA and Tukey's tests (α=0.05). RESULTS: The mean fracture resistance values were as follows: Group 1: 573.3 N; Group 2: 552.5 N; Group 3: 275.3 N; Group 4: 258.6 N. Significantly higher fracture resistance was found for the groups with Fp (p<0.001). CONCLUSION: There was no statistically significant interaction between the "Fp" and "post" factors (p = 0.954). The ferrule preparation increased the fracture resistance of endodontically treated teeth. However, the use of glass fiber post showed no significant influence on the fracture resistance.

Effect of chlorhexidine concentration on the bond strength to dentin in primary teeth

PURPOSE: To evaluate the effect of the use of 0.5% and 2% chlorhexidine digluconate on the immediate bond strength of a conventional adhesive system to dentin in primary teeth. METHODS: Twenty-one healthy primary molars were divided into three groups (n=7), being one control (A) and two experimental groups (B and C). After dentin exposure, in Group (A) the adhesive procedure was performed using 37% phosphoric acid gel (15 s); dentin was washed (15 s), air dried (30 s) and rehydrated with water. Groups B and C followed similar procedures but for re-hydration with 0.5% and 2% chlorhexidine, respectively, for 30 s. A resin composite block was built simulating a restoration, and the teeth were stored in distilled water at 37°C for 24 h before the microtensile bond strength test. The bond strength data were analyzed by analysis of variance. RESULTS: No statistically significant difference in bond strength was found among the tested groups (P>0.05) CONCLUSION: The 0.5% and 2% concentrations of chlorhexidine presented similar behavior and caused no adverse effects on the bond strength to dentin in primary teeth.

Use of flowable composite as intermediary layer in non-carious cervical lesions restored with composite resin: 48-month follow-up

PURPOSE: In this case report, the clinical performance of a microhybrid resin composite placed with or without a flowable resin composite was compared, over a 48-month period. CASE DESCRIPTION: The patient of this case report presented 2 pairs of equivalent cervical abfraction lesions, under occlusion. Four restorations were placed in teeth 34, 35, 44 and 45. The restorations were divided into groups (Single Bond + Filtek-Flow + Filtek Z250 or Single Bond + Filtek Z250) and the materials were applied according to the manufactures instructions. Two previously calibrated operators placed the restorations and two other independent examiners evaluated the restorations at baseline and after 48 months, according to the USPHS criteria and modified criteria for color match. CONCLUSION: After 48 months of evaluation the lesions restored with Filtek-Flow as a liner under Filtek Z250 did not show better clinical performance than the restorations without Filtek-Flow. All restorations showed a trend toward dark yellowing after 48 months.

Evaluation of the Bond Strength Between a Composite Resin and Enamel Submitted to Bleaching Treatment and Etched with Er:YAG Laser

Background: The use of laser irradiation for dental surface treatment may increase tooth-composite bond strength. Its use on bleached teeth may decrease the waiting time between bleaching and restorative procedures. Objective: This study aimed to evaluate the bond strength between a composite resin and bovine enamel bleached with 35% hydrogen peroxide and etched with Er:YAG laser. Materials and Methods: Thirty bovine teeth were randomly divided into six groups (n = 5): G1, unbleached and restored 24 h after storage in artificial saliva, etching with 35% phosphoric acid (PA) (control); G2, unbleached and restored 24 h after storage in artificial saliva, etching with Er:YAG laser and 35% PA; G3, bleached and restored immediately afterward, etching with 35% PA; G4, bleached and restored 24 h after bleaching, etching with 35% PA; G5, bleached and restored immediately afterward, etching with Er:YAG and 35% PA laser; G6, bleached and restored 24 h after bleaching, etching with Er:YAG laser and 35% PA. Bond strength was quantitatively evaluated by microtensile test (1.0 mm/min). Data were submitted to statistical analysis using ANOVA and Tukey tests (alpha - 0.05). Results: Bond strength values (MPa) were G1, 26.17 +/- 4.44; G2, 28.87 +/- 3.94; G3, 17.25 +/- 4.58; G4, 21.93 +/- 5.02; G5, 16.69 +/- 2.31; and G6, 29.06 +/- 8.31. There was no statistically significant difference among groups G1, G2, and G6 (p - 0.119), which presented higher bond strength than group G4, followed by groups G3 and G5. Conclusion: Er:YAG irradiation of bleached surfaces may favor bonding procedures when performed 24 h after bleaching.

Apical Leakage of Three Resin-Based Endodontic Sealers after 810-nm-Diode Laser Irradiation

Objective: To evaluate the influence of 810-nm-diode laser irradiation, applied before root canal filling, on apical sealing ability of three different resin-based sealers (AH Plus, EndoRez, and RealSeal). Background: Lasers have been widely used in endodontics. The dentin wall changes caused by laser irradiation could improve the sealing ability of endodontic cements. Methods: Sixty single-rooted human teeth were divided into six groups, according to the endodontic sealer used and previous 810-nm-diode laser irradiation. The protocol for laser irradiation was 2.5W in a continuous wave, in scanning mode, with four irradiations per tooth. After sample preparation, they were analyzed according to apical leakage with silver nitrate impregnation. Results: The RealSeal sealer achieved minimum leakage rates (1.24 mm), with significant differences at the 1% level (Tukey's test, p < 0.01) from AH Plus (1.84 mm) in nonirradiated groups. When the laser was used, there were also significant differences at the 5% level (p < 0.05) between irradiated groups (1.31 and 1.78 mm, respectively). Conclusion: The 810-nm-diode laser irradiation did not promote significant differences in apical leakage.