Clinical evaluation of two packable resin-based composite restorations: A three-year report

This randomized clinical trial sought to evaluate the performance of two packable composites over a period of 36 months. A total of 39 Class I and II restorations were placed in the permanent teeth of 20 patients. Using United States Public Health Services criteria, two investigators evaluated the restorations immediately after placement and again after 12 and 36 months, examining color match, marginal discoloration, marginal integrity, recurrent caries, proximal contact, anatomical shape, surface texture, and postoperative sensitivity. It was concluded that the packable composites evaluated showed satisfactory clinical performance after three years.

Clinical evaluation of a composite resin and a resin-modified glass-ionomer cement in non-carious cervical lesions: One-year results

Objectives: The objective of this study was to evaluate the clinical performance of 124 non-carious cervical lesion restorations at 12 months. Materials And Methods: Three study groups were formed according to the material and technique used. All teeth received 37% phosphoric acid etching in enamel and dentin. The teeth of Group I received the conventional adhesive system Scotch Bond Multi Purpose, followed by resin composite Filtek Z350; teeth of Group II were restored with resin-modified glassionomer cement Fuji II LC; teeth of Group III were restored with the same resin-modified glass-ionomer cement-however, before it was inserted, 2 coats of primer of the Scotch Bond Multi Purpose adhesive system were applied to dentinal tissue. The teeth were evaluated by 2 examiners with regard to the factors of retention, marginal adaptation, marginal discoloration, color alteration, presence of marginal caries lesion, anatomic shape, and sensitivity. Results: Application of the Kruskal-Wallis test showed no statistically significant difference for anatomic shape, marginal discoloration, color alteration, caries lesion, marginal adaptation, and sensitivity among the three study groups, but the variable retention presented statistically significant difference at 12 months, with Group III presenting a behavior superior to that of Group II but similar to that of Group I. Conclusion: The analyzed restorations of non-carious cervical lesions presented a good clinical performance at 12 months. © 2012 Nova Science Publishers, Inc.

Avaliação da fenda e microinfiltração marginal em restaurações de classe II de resina composta, usando as técnicas direta e indireta

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

Avaliação da adaptação marginal de restaurações cerâmicas inlay após a cimentação

Pós-graduação em Odontologia Restauradora - ICT

Adaptação marginal e resistência à fratura de coroas totais executadas em diferentes sistemas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Resistência de união e discrepância marginal absoluta de infraestruturas feitas em cerâmica Y-TZP: influência de novos métodos de tratamento de superfície

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The effect of an Er,Cr:YSGG laser on external adaptation of healthy and decayed cavities

The aim of this study was to evaluate the influence of chlorhexidine and Er, Cr:YSGG laser irradiation on the bond strength and external adaptation in mixed healthy and caries-affected class V cavities before and after thermal cycling. Thirty-six cavity preparations were made in mixed class V buccal human molars, half of them being artificially caries-induced. Any remaining affected dentin was removed from the cavity with a round burr at low speed. The teeth were divided into six groups, according to cleaning agent for both healthy and caries-induced dentin: no treatment, chlorhexidine and erbium, chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation. A Filtek P90 (3M ESPE, St Paul, MN, USA) silorane adhesive restorative system was used. The specimens were subjected to 5000 thermal cycles (5-55 degrees C 60 min). Epoxy replicas were obtained to characterize the external adaptation under scanning electron microscopy. The average percentages of non-continuous margins were 5.41% and 6.49% in enamel dentin before thermal cycling and 25% and 33.7% after thermal cycling, respectively. The caries-affected and laser irradiated cavities showed higher non-continuous margins. Thermal cycling was able to raise the percentage of non-continuous margin for all groups. Chlorhexidine did not affect the marginal adaptation results, and the Er,Cr:YSGG laser irradiation showed significantly worse results compared with the control group.

A split-mouth randomized clinical trial of conventional and heavy flowable composites in class II restorations

Objective: The aim of this study was to evaluate the 2-year clinical performance of class II restorations made with a composite resin with two different viscosities.Methods: 47 patients received two class II restorations (n = 94), one made with GrandioSO (conventional viscosity CV), and the other with GrandioSO Heavy Flow (flowable viscosity FV), subjecting both materials to the same clinical conditions. The self-etching adhesive Futurabond M was used for all restorations. The composites were inserted using the incremental technique. The restorations were evaluated using the modified USPHS criteria according to the periods: baseline, 6 months, 1 year and 2 years after restorative procedures.Results: After 24 months, 40 patients attended the recall and 78 restorations were evaluated. In all periods, no secondary caries was observed. After 6 months, there were slightly overall changes of scores for most parameters. After 24 months, the higher number of changes from score Alfa to Bravo was observed for marginal discolouration (32.5% CV and 39.5% FV) and colour match (15% CV and 31.6% FV), followed by proximal contact (25% CV and 23.7% FV) and marginal adaptation (20% CV and 21.1% FV). For wear, surface texture and postoperative sensitivity the changes were very small. Just two restorations were lost during the 24-month follow up. Less than 5% of all restorations showed postoperative sensitivity. Chi-square test showed no significant differences between the two materials for all parameters analysed.Conclusion: After 2 years of clinical service, no significant differences were observed between GrandioSO conventional and GrandioSO Heavy Flow for the parameters analysed. Both materials provided acceptable clinical behaviour in class II restorations. Clinical Significance: This study presents the possibility of using a flowable composite with high filler content, for performing class II restorations. (C) 2014 Elsevier Ltd. All rights reserved.

Influência do ciclo de sinterização da porcelana na adaptação marginal de infraestruturas de NiCrTi em função da biomecânica do preparo

A metal coping may undergo changes during porcelain firing, which compromises its marginal adaptation. The use of NiCrTi alloy proposes to minimize this effect through the high melting point of titanium present in its composition. This study evaluated the influence of porcelain firing cycle on the marginal adaptation of NiCrTi copings in different preparation designs. Forty standardized metal dies were fabricated with the following combinations finish line/convergence of the axial walls: 1) shoulder/6°; 2) shoulder/20°; 3) sloping shoulder/6°; 4) sloping shoulder/20°. On each die a metal ceramic restoration coping was made. The die/coping set was stabilized with orthodontic elastics, divided into four equidistant areas with three measurement points each and a cementation pressure was simulated. The measurements were taken under a stereomicroscope (32×). After the first measurement, the copings were submitted to sintering cycles simulating porcelain application. For repeated measurements, the same procedures described above were performed. Data were submitted to Student’s-t test, 1-way ANOVA and Tukey´s test (α = 0.05). Adaptation means (µm) before and after porcelain firing in different preparations were: 1) 111.92 and 127.31; 2) 124.15 and 135.48; 3) 122.19 and 138.77; 4) 166.09 and 186.72; respectively. The porcelain firing impaired adaptation, regardless of the preparation design. The preparation in a 20° sloping shoulder provided a worse adaptation when compared with preparations that had 6° and 20° shoulder, which were statistically equal. The 6° sloping shoulder was statistically equal to the other three preparation designs.

Adaptação marginal do agregado de trióxido mineral com e sem cloreto de cálcio em retrocavidades

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

Can repair increase the longevity of composite resins? Results of a 10-year clinical trial

The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. Methods Twenty-eight patients aged 18–80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were “clinically judged” to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n = 25) or Replacement (n = 25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. Results Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p > 0.05), secondary caries (SC) (p > 0.05), anatomy (A) (p < 0.05), and colour (C) (p > 0.05). Conclusions Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. Clinical significance The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.

Effects of Er, Cr:YSGG laser irradiation on external adaptation of restorations in caries-affected cavities

This study evaluated the effect of Er,Cr:YSGG laser irradiation on the external adaptation of composite resin restorations in caries-affected cavities. Mixed class V cavity preparations were performed in 36 intact human third molars, in half of which caries was artificially induced. Both healthy and carious dentin were etched with 35% phosphoric acid (Ultradent Products Inc., South Jordan, Utah, USA), and the teeth were divided into three groups, i.e., (a) untreated etched dentin, (b) application of the Er, Cr:YSGG laser and (c) use of chlorhexidine as an adjunct in the bonding process. Restorations were fabricated with Z350 XT FiltekTM composite resin (3M ESPE) and subsequently the specimens were subjected to thermocycling to simulate artificial ageing. Quantitative analysis of external adaptation was performed by scanning electron microscopy in both healthy and affected dentin using epoxy resin replicas. It was concluded that the application of laser and chlorhexidine did not affect the percentages of marginal adaptation of class V restorations. Furthermore, thermocycling may influence adaptation values.

Evaluation of dental restorations: a comparative study between clinical and digital photographic assessments

The aim of this study was to compare the efficacy of a direct clinical evaluation method with an indirect digital photographic method in assessing the quality of dental restorations. Seven parameters (color, occlusal marginal adaptation, anatomy form, roughness, occlusal marginal stain, luster, and secondary caries) were assessed in 89 Class I and Class II restorations from 36 adults using the modified US Public Health Service/Ryge criteria. Standardized photographs of the same restorations were digitally processed by Adobe Photoshop software, separated into the following four groups and assessed by two calibrated examiners: Group A: The original photograph displayed at 100%, without modifications (IMG100); Group B: Formed by images enlarged at 150% (IMG150); Group C: Formed by digital photographs displayed at 100% (mIMG100), with digital modifications (levels adjustment, shadow and highlight correction, color balance, unsharp Mask); and Group D: Formed by enlarged photographs displayed at 150% with modifications (mIMG150), with the same adjustments made to Group C. Photographs were assessed on a calibrated screen (Macbook) by two calibrated clinicians, and the results were statistically analyzed using Wilcoxon tests (SSPS 11.5) at 95% CI. Results: The photographic method produced higher reliability levels than the direct clinical method in all parameters. The evaluation of digital images is more consistent with clinical assessment when restorations present some moderate defect (Bravo) and less consistent when restorations are clinically classified as either satisfactory (Alpha) or in cases of severe defects (Charlie). Conclusion: The digital photographic method is a useful tool for assessing the quality of dental restorations, providing information that goes unnoticed with the visual-tactile clinical examination method. Additionally, when analyzing restorations using the Ryge modified criteria, the digital photographic method reveals a significant increase of defects compared to those clinically observed with the naked eye. Photography by itself, without the need for enlargement or correction, provides more information than clinical examination and can lead to unnecessary overtreatment.

Sealing composite with defective margins, good care or over treatment? results of a 10-year clinical trial

Purpose: The objective of this study was to clinically evaluate sealed composite restorations after 10 years and compare their behavior with respect to controls. Methods and Materials: The cohort consisted of 20 patients aged 18 to 80 years with 80 composite restorations. All participants in the sealing and no-treatment groups presented with clinical features for the marginal adaptation that deviated from the ideal and were rated Bravo (United States Public Health Service criteria). Composites with Alfa values for the marginal adaptation were used as the positive control. Results: The marginal adaptation behavior was similar between the sealing and control (+) groups, with a high frequency of Bravo values in the 10th year (80% and 51%, respectively). Most of the no-treatment (-) group maintained the Bravo values (91%) for 10 years, although some restorations (9%) progressed to Charlie values. The anatomy parameter differed significantly between the first and 10th years, with deterioration in all three groups (p,0.05). The secondary caries parameter had a similar behavior in the three groups (p.0.05). Conclusions: Sealing the margins of the composite resin restorations had no significant effect compared with the control groups, under the conditions of this study. Sealing the restorations substantially improved the marginal staining and marginal adaptation parameters, although by the tenth year they were similar to the group without intervention.

Influência de técnicas de moldagem e de dois vazamentos na precisão dimensional de modelos de gesso e adaptação marginal de infraestruturas CAD/CAM em Y-TZP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)