Restorative treatment on class I and II restorations in primary molars: A survey of Brazilian dental schools

A survey was sent to 70 Brazilian dental schools evaluating techniques and restorative materials being taught for Class I and II preparation in posterior primary teeth by Pediatric Dentistry courses. After a 54% response rate, marked teaching diversity was found among Brazilian dental schools. Amalgam continues to be taught, but a tendency of preference towards more esthetic-like materials was observed.

Effect of 10% carbamide peroxide dental bleaching on microhardness of filled and unfilled sealant materials

Purpose: The purpose of this study was to quantitatively evaluate the effect of 10% carbamide peroxide on the microhardness of pit and fissure sealant materials. Methods: Fluroshield, Vitroseal Alfa, and one unfilled (Clinpro) sealants were placed in Teflon matrices (4 mm in diameter by 2 mm in height) and polymerized for 40 seconds. A total of 20 specimens were prepared for each material, in which half were assigned as the control group (stored in artificial saliva and no bleaching treatment). For the remaining half, Clarigel Gold bleaching agent (10% carbamide peroxide) was placed over the specimen surface for 4 hours/day during 4 weeks. When specimens were not under bleaching treatment, they were kept in artificial saliva. Afterwards, specimens were subjected to Knoop microhardness testing using a 25-g load for 5 seconds. Five measurements were made on the sealants' surfaces and then calculated in Knoop hardness values. The data were statistically analyzed by two-way analysis of variance and Tukey's tests with a 5% confidence level. Results: The results of this in vitro study showed that the application of a carbamide peroxide-based bleaching material significantly affected the microhardness values of filled sealant materials. The bleaching agent did not affect the microhardness of the unfilled sealant. CLINICAL SIGNIFICANCE: The results of this in vitro study suggest that the bleaching agents altered the surface hardness of filled sealant restorative materials. This could possibly lead to increased wear and surface roughness. © 2006, Copyright the authors.

Influence of bleaching treatment on flexural resistance of hybrid materials.

The aim of this study is to evaluate the flexural resistance of three types of restorative materials: compomer (Freedom), resin-modified glass-ionomer (Vitremer) and composite resin (Esthet-X), observing whether the application of bleaching agent can cause alterations of their flexural properties. Sixty samples were made using a 10 x 1 x 1 mm brass mold, and divided into three groups: G1- Freedom (SDI); G2- Vitremer (3M ESPE); G3- Esthet-X (Dentsply). On half of the samples of each group (10 samples) the bleaching treatment was applied and the other half used as control, was stored in distilled water at a temperature of 37 degrees C. Whiteness HP Maxx bleaching system was applied on the sample surface following the manufacturer's recommendations, simulating the bleaching treatment at the clinic. After this period, a flexural strength (three-point bending) test was conducted using (EMIC DL 1000) machine until the samples fractured. The data were submitted to ANOVA and Tukey tests. Of the restorative materials studied, G3-(87.24 +/- 31.40 MPa) presented the highest flexural strength, followed by G1-(61.67 +/- 21.32 MPa) and G2-(61.67 +/- 21.32 MPa). There was a statistical difference in flexural strength after the bleaching treatment. It was concluded that the use of a beaching agent can promote significant alteration of the flexural strength of these restorative materials.

Influence of fluoride-releasing restorative material on root dentine secondary caries in situ

The usefulness of fluoride-releasing restorations in secondary caries prevention may be questioned because of the presence of other common sources of fluoride and because of ageing of the restorations. This study tested the hypothesis that glass-ionomer cement restorations, either aged or unaged, do not prevent secondary root caries, when fluoride dentifrice is frequently used. Sixteen volunteers wore palatal appliances in two phases of 14 days, according to a 2 x 2 crossover design. In each phase the appliance was loaded with bovine root dentine slabs restored with either glass-ionomer or resin composite, either aged or unaged. Specimens were exposed to cariogenic challenge 4 times/day and to fluoridated dentifrice 3 times/day. The fluoride content in the biofilm (FB) formed on slabs and the mineral loss (Delta Z) around the restorations were analysed. No differences were found between restorative materials regarding the FB and the Delta Z, for either aged (p = 0.792 and p = 0.645, respectively) or unaged (p = 1.00 and p = 0.278, respectively) groups. Under the cariogenic and fluoride dentifrice exposure conditions of this study, the glass-ionomer restoration, either aged or unaged, did not provide additional protection against secondary root caries. Copyright (c) 2006 S. Karger AG, Basel.

Caries formation around restorative composite and glass ionomer cement

This in vitro study evaluated the demineralization around restorations class V made on the buccal and lingual surfaces of teeth when using different restorative materials. Thirty extracted teeth were randomly divided into 3 groups (n=10) according to the restorative material: Group I - Fuji II LC (GC America Inc., Alsip, Illinois, USA), Group II - Tetric (Ivoclar Vivadent AG, Schaan, Liechtenstein) and Group III - Chelon Fil (3M/ESPE., Seefeld, Germany). The teeth were submitted to a pH-cycling model associated to a thermocycling model. Sections were made and the specimens were analyzed under a polarized light microscopy as for the presence of demineralization. Measurements were performed and the results were subjected to statistical analysis using Anova and Tukey´s Test (α=0.05). Mean values of demineralization depth (µm) according to each positions showed that the demineralization was significantly reduced when Chelon Fil (Group III) was used for all depths, when compared to fluoridated resin materials. Also, it was verified that non-fluoridated resin material, composite resin Tetric, had the lowest inhibitory effect on the development of demineralization.

Genotoxicity and cytotoxicity of glass ionomer cements on Chinese hamster ovary (CHO) cells

Glass ionomer cements are widely used in dentistry as restorative materials and adhesives for composite restorations. However, the results of genotoxicity studies using these materials are inconclusive in literature. The goal of this study was to examine the genotoxic and cytotoxic potential of three different glass ionomer cements available commercially (Ketac Cem, Ketac Molar and Vitrebond) by the single cell gel (comet) assay and trypan blue exclusion test, respectively. For this, such materials were exposed to Chinese hamster ovary (CHO) cells in vitro for 1 h at 37 degrees C. Data were assessed by Kruskall-Wallis nonparametric test. The results showed that the powder from Ketac Molar displayed genotoxicity only in the maximum concentration evaluated (100 mu g/mL). In the same way, the liquid from Vitrebond at 0.1% dilution caused an increase of DNA injury. Significant differences (P < 0.05) in cytotoxicity provoked by all powders tested of glass ionomer cements were observed for exposure at 1000 mu g/mL concentration. With respect to liquids of glass ionomer cements evaluated, the major toxic effect on cell viability was produced at 10%, beginning at the dilution of 0.5% for Vitrebond. Taken together, we conclude that some components of glass ionomer cements show both genotoxic and cytotoxic effects.

Biocompatibility of glass-ionomer cements using mouse lymphoma cells in vitro

Glass-ionomer cements are widely used in dentistry as restorative materials and adhesives for composite restorations. A number of genotoxicity studies have been conducted using these materials with results conflicting so far. Thus, the approach was aimed to look at the genotoxic and cytotoxic potential of three different glass-ionomer cements available commercially (Ketac Cem, Ketac Molar and Vitrebond) by the single cell gel (comet) assay and trypan blue exclusion test, respectively. For this, such materials were exposed to mouse lymphoma cells in vitro for 1 h at 37 degrees C. Data were assessed by Kruskall-Wallis non-parametric test. The results showed that all powders assayed did not show genotoxic effects. on the other hand, the liquid from Vitrebond at 0.1% dilution caused an increase of DNA injury. Significant statistically differences (P < 0.05) in cytotoxicity provoked by all powders tested were observed for exposure at 1000 mu g mL(-1) concentration and 100 mu g mL(-1) for Ketac Molar. With respect to liquids of glass-ionomer cements evaluated, the major toxic effect on cell viability was produced at 1%, beginning at the dilution of 0.5% for Vitrebond. Taken together, these results support the notion that some components of glass-ionomer cements show both genotoxic and cytotoxic effects in higher concentrations.

Influência da aplicação de flúor sobre a rugosidade superficial do ionômero de vidro Vitremer e adesão microbiana a este material

Os cimentos ionoméricos representam importante opção de material restaurador em Odontologia e sua adesão à estrutura dental, diminuindo a infiltração marginal, somada à liberação de flúor, inibindo o metabolismo de microrganismos acidogênicos e favorecendo a remineralização dental, podem diminuir a ocorrência de cárie secundária. A aplicação tópica de géis acidulados ou neutros contendo flúor tem sido largamente utilizada em Odontologia. No entanto, este procedimento pode afetar a integridade dos materiais restauradores, aumentando sua rugosidade e a retenção de placa bacteriana. Dessa forma, o presente estudo avaliou o período de tempo no qual o cimento ionomérico Vitremer mantém sua capacidade inibitória sobre Streptococcus mutans ATCC 25175 e a adesão dos mesmos sobre a superfície do material, bem como a influência da aplicação tópica de flúor acidulado e neutro sobre esses parâmetros microbiológicos e as características superficiais daquele material. Verificou-se que a atividade antimicrobiana do cimento ionomérico Vitremer se mantém por aproximadamente quatro dias e não é recuperada com o uso de flúor gel acidulado ou neutro. Observou-se, também, que Streptococcus mutans ATCC 25175 adere ao material restaurador testado sendo que a aplicação tópica de flúor não influenciou esta adesão. As características superficiais desses materiais não se alteraram com a aplicação dos géis.

Cementation of Prosthetic Restorations: From Conventional Cementation to Dental Bonding Concept

The cementation procedure of metal-free fixed partial dentures exhibits special characteristics about the porcelains and cementation agents, which turns the correct association between these materials necessary. Our purpose in this literature review was to point the main groups of cements associated to metal-free restoration and discuss about the advantages, disadvantages, and recommendations of each one. Our search was confined to the electronic databases PubMed and SciELO and to books about this matter. There are essentially 3 types of hard cement: conventional, resin, or a hybrid of the two. The metal-free restorations can be fixed with conventional or resin cements. The right choice of luting material is of vital importance to the longevity of dental restorative materials. Conventional cements are advantageous when good compressive straight, good film thickness, and water dissolution resistance are necessary. However, they need an ideal preparation, and they are not acid dissolution resistant. Conventional cements are indicated to porcelains that cannot be acid etched. Resin cements represent the choice to metal-free restoration cementation because they present better physical properties and aesthetic than conventional agents.

Analysis of surface roughness of glass-ionomer cements and compomer

The purpose of this study was to evaluate the surface roughness of two glass-ionomer cements (Vitremer and Chelon-Fil), and one compomer (Dyract) when submitted to different finishing/polishing procedures at different times. A hundred 80-sample discs were made of each material and randomly divided into six finishing/polishing groups: mylar strip (control); Sof-Lex discs; diamond burs; diamond burs/Sof-Lex discs; 30-fluted carbide bur; 30-fluted carbide bur/Sof-Lex discs. These procedures were carried out immediately after preparation of the samples, after 24 and 168 h. Average surface roughness (Ra) was measured with a profilometer and the values were compared using anova (P < 0.05). The smoothest surface for all materials was obtained when cured in contact with the mylar strip. All other tested products increased surface roughness of restorative materials, but Sof-lex discs lead to better results. The worst results were verified with diamond burs. The finishing/polishing procedures, when performed immediately, can improve the roughness of glass-ionomer cements but not of the compomer tested.

Direct Esthetic Restorations Based on Translucency and Opacity of Composite Resins

Light dynamics is a relevant phenomenon with respect to esthetic restorations, as incorrect analysis of the optical behavior of natural dentition may lead to potential clinical failures. The nature of incident light plays a major role in determining the amount of light transmission or reflection, and how an object is perceived depends on the nature of the light source. Natural teeth demonstrate translucency, opalescence, and fluorescence, all of which must be replicated by restorative materials in order to achieve clinical success. Translucency is the intermediary between complete opacity and complete transparency, making its analysis highly subjective. In nature, the translucency of dental enamel varies from tooth to tooth, and from individual to individual. Therefore, four important factors must be considered when appraising translucency. Presence or absence of color, thickness of the enamel, degree of translucency, and surface texture are essential components when determining translucency. State-of-the-art resin composites provide varying shades and opacities that deliver a more faithful reproduction of the chromaticity and translucency/opacity of enamel and dentin. This enables the attainment of individualized and customized composite restorations. The objective of this article is to provide a review of the phenomena of translucency and opacity in the natural dentition and composite resins, under the scope of optics, and to describe how to implement these concepts in the clinical setting.CLINICAL SIGNIFICANCEChoosing composite resins, based on optical properties alone, in order to mimic the properties of natural tooth structures, does not necessarily provide a satisfactory esthetic outcome. In many instances, failure ensues from incorrect analysis of the optical behaviors of the natural dentition as well as the improper use of restorative materials. Therefore, it is necessary to implement a technique that enables a restorative material to be utilized to its full potential to correctly replicate the natural teeth.(J Esthet Restor Dent 23:73-88, 2011).

Surface Roughness and Bacterial Adherence to Resin Composites and Ceramics

Purpose: The aim of this study was to evaluate the surface roughness and the in vitro adherence of Streptococcus mutans to indirect aesthetic restorative materials that are uncoated with saliva.Materials and Methods: Four groups of restorative materials were evaluated according to material type: (1) microparticulate feldspathic ceramic; (2) leucite-reinforced feldspathic ceramic; (3) microhybrid resin composite and (4) microfilled resin composite. Twenty standardised samples of each material were produced. Roughness analysis (Ra, n = 10) was performed using a roughness analyser. Adhesion tests (n = 10) were carried out in 24-well plates; colony-forming units (CFU/mL) were evaluated. The mean values of roughness (mu m) and adherence (CFU/mL) for each group were subjected to an analysis of variance and a Tukey test.Results: The leucite-reinforced feldspathic ceramic was rougher and presented higher bacterial adherence than the microparticulate feldspathic ceramic. The resin composites were similar with regard to surface roughness and bacterial adherence.Conclusions: The microhybrid and microfilled resin composites were similar and the leucite-reinforced feldspathic ceramic was rougher and presented higher bacterial adherence than the microparticulate feldspathic ceramic.

Rugosidade e pigmentação superficial de materiais ionoméricos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Development of an experimental glass ionomer cement containing niobium and fluoride

Glass ionomer cements (GICs) are currently used for various dental applications such as luting cements or as restorative materials. The calcium fluoro-alumino-silicate system is the basis for degradable glasses used to obtain the GICs. The purpose of the present paper is to add niobium to conventional glass system because according to previous papers niobium addition improves the chemical resistance and the mechanical properties of glasses. Therefore, the GICs prepared from these glasses would result in cements with higher chemical and mechanical resistance. The niobium fluoride powders were prepared using the sol-gel process and were characterized by X-ray diffraction, differential thermal analysis (DTA) and Al-27 and Si-29 MAS NMR. The results obtained by XRD showed that the powders prepared by this method are glass-ceramic. In the DTA curve was detected the presence of T-g and T-c temperatures. The analysis of MAS NMR spectra indicated that the framework of the powders is formed by SiO4 and AlO4 linked tetrahedra which are essential structures to yield the cements. Thus, we concluded that niobium fluoride silicate powders can be used in the preparation of GICs. (c) 2005 Elsevier B.V. All rights reserved.

Knoop hardness of dental resin cements: Effect of veneering material and light curing methods

This study evaluated the Knoop hardness of one resin cement (dual-cure mode or light-cure mode) when illuminated directly or through restorative materials-ceramic (HeraCeram) or composite (Artglass)-by two light curing units. Light curing was carried out using a conventional quartz tungsten halogen (QTH) light source (XL2500) for 40 s, and a light emitting diodes (LED) light source (Ultrablue Is) for 40 s. Bovine incisors had their buccal faces flattened and hybridised. on these surfaces, a mould was seated and filled with cement. A disc of the veneering material (1.5 mm thickness) was positioned over this set for light curing. After storage (24 h/37 degrees C), samples (n = 10) were sectioned for hardness (KHN) measurements. Data were submitted to ANOVA and to Tukey's test (alpha = 0.05). In general, light curing with LED resulted in higher hardness values than QTH. Distinct cement behaviour was observed with different veneering material in association with different light curing units (LCUs). (C) 2006 Elsevier Ltd. All rights reserved.