Evaluation of enamel surface after bracket debonding and polishing

INTRODUÇÃO: a preservação da estrutura de esmalte após a remoção dos acessórios ortodônticos é obrigação do clínico. Portanto, procura-se um protocolo de descolagem com bases científicas. OBJETIVO: objetivou-se avaliar por microscopia eletrônica de varredura (MEV) a influência de quatro protocolos de remoção de braquetes e polimento da superfície do esmalte e propor um protocolo que minimize os danosà superfície do esmalte. MÉTODOS: doze incisivos permanentes bovinos foram divididos em quatro grupos de acordo com os instrumentos utilizados para a descolagem dos braquetes e remoção do remanescente adesivo. Os braquetes foram descolados com o alicate de descolagem reto (Ormco Corp.) nos grupos 1 e 2, e com o instrumento de descolagem Lift-Off (3M Unitek) nos grupos 3 e 4. Os remanescentes adesivos dos grupos 1 e 3 foram removidos com o alicate removedor de resina longo (Ormco Corp.) e dos grupos 2 e 4 com broca de carboneto de tungstênio (Beavers Dental) em alta-rotação. As superfícies, após cada etapa da descolagem e polimento, foram avaliadas em réplicas de resina epóxica e foram obtidas eletromicrografias com aumento de 50 e 200X. RESULTADOS: os quatro protocolos de remoção de acessórios ortodônticos e polimento ocasionaram irregularidades no esmalte. Conclusão: a remoção do braquete com o alicate de descolagem reto, seguido da remoção do remanescente adesivo com broca de carboneto de tungstênio e polimento final com pasta de pedra-pomes foi o procedimento que ocasionou menores danos ao esmalte, sendo o protocolo sugerido para a remoção dos acessórios ortodônticos.

Effects evaluation of remaining resin removal (three modes) on enamel surface after bracket debonding

Introduction: An appropriate selection of instruments is essential to perform a correct debonding technique, by properly removing orthodontic brackets and the remaining resin. Objective: The aim of this study was to evaluate three methods of remaining resin removal on enamel surface after bracket debonding, by means of Scanning Electron Microscopy (SEM). Methods: Eighteen bovine incisors were selected and divided into three groups (A, B and C) of six teeth each. Before bracket bonding, epoxy resin casts were obtained by impression of the teeth with addition silicon, in order to register baseline enamel characteristics and representing the control group. The methods for remaining resin removal were: Group A - gross and medium granulation Soflex discs; Group B - carbide bur in low-speed; Group C - carbide bur in high-speed. Soflex polishing system fine and ultrafine granulation discs were used for Group A, rubber tips for Groups B and C, and polishing paste for all groups. After polishing, impression of teeth were taken and casts were analyzed by means of SEM. The baseline enamel characteristics (Control Group) were compared to the final aspect of enamel to determine the method that generated less enamel abrasion. Results and Conclusion: The remaining resin removal by carbide bur in low-rotation, and enamel polished with rubber tips followed by polishing paste produced the smaller damage to the enamel.

Methods for removal of resin remaining after debonding of orthodontic brackets: a literature review

The removal of resin debris and/or resin cement from the enamel surface without causing iatrogenic is the main objective when removing the orthodontic brackets. Some factors such as the time required for removal, damage to the tooth structure, are essential factors for the clinician at the time of removal. Various techniques are used for the removal of orthodontic brackets after the treatment; it is known that the use of clinical procedures such as the use of diamond burs and some pliers removers can damage the structure of the enamel, often depending on the bond strength that should be taken into consideration at the time of removal. This literature review aims to gather the most relevant studies that can clarify the clinical technique, which may be more suitable for removal of the brackets.

Avaliação do Índice de Remanescente Adesivo utilizando braquetes com e sem tratamento na base e a interação com três sistemas de colagem

OBJETIVO: avaliar o Índice de Remanescente Adesivo (IRA) em dentes bovinos após a descolagem de braquetes com e sem tratamento na base. METODOLOGIA: foram utilizados três sistemas de colagem ortodôntica para os dois padrões de base. Os dentes bovinos foram divididos em seis grupos de 40, de acordo com a base do braquete e o sistema de colagem. Vinte e quatro horas após a colagem foram realizados os testes de compressão em uma máquina de ensaios. A avaliação do IRA foi realizada em um estereomicroscópio por três examinadores calibrados. Foi utilizado o teste não paramétrico de Kruskal-Wallis, seguido do método de Dunn, para fazer as comparações múltiplas entre todos os grupos. RESULTADOS E CONCLUSÕES: observou-se que o tratamento das bases dos braquetes com óxido de alumínio não foi determinante para o aumento da adesividade entre o braquete e o adesivo. O grupo em que se utilizou braquetes com tratamento na base e adesivo TXT (3M-Unitek) + Transbond Plus SEP (3M-Unitek) apresentou a maior parte das fraturas na interface dente-adesivo (escore 4).

Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment - Case reports

This article reports clinical procedures used to remove residual bonded resin and enamel stains following bracket debonding at the conclusion of orthodontic treatment. A water-cooled fine-tapered diamond bur was used for resin removal, followed by enamel surface finishing using a commercially available microabrasion paste. It was noted that residual tooth coloration remained yellowish because of enamel translucency; the yellow dentin shade showed through. Additional tooth shade lightening was achieved using carbamide peroxide dental bleaching solution in custom-formed trays. This report describes a safe and effective technique that optimizes tooth appearance at the conclusion of orthodontic therapy. Mechanical resin removal, enamel microabrasion, and tooth bleaching are employed.

Estudo in vivo e in vitro com e sem termociclagem, da resistência ao cisalhamento de braquetes colados com fonte de luz halógena

OBJETIVO: avaliar a resistência de braquetes metálicos colados em dentes humanos com resina polimerizada com luz halógena por meio de ensaios mecânicos de cisalhamento. METODOLOGIA: para este estudo foram realizados ensaios in vivo com dinamômetro portátil digital e in vitro com máquina de ensaios mecânicos universal com e sem termociclagem, complementado pelo Índice de Adesivo Remanescente (IAR). Braquetes Edgewise Standard (Abzil) foram colados utilizando adesivo Transbond Plus Self Etching Primer (SEP) e Resina Transbond XT. Foram formados 3 grupos com 10 dentes em cada um deles. No GI os braquetes foram colados nos segundos pré-molares dos pacientes. Nos GII e GIII utilizaram-se primeiros pré-molares extraídos por motivos ortodônticos. Os ensaios mecânicos do GI foram realizados 24 horas após a polimerização diretamente na boca dos pacientes com dinamômetro portátil digital. No GII os corpos-de-prova foram armazenados em água destilada e levados à estufa a 37ºC durante 24 horas e, posteriormente, submetidos à termociclagem, com 1000 ciclos a 5 e 55ºC. No GIII os corpos-de-prova foram armazenados em água destilada em temperatura ambiente por 24 horas e posteriormente submetidos aos ensaios mecânicos. RESULTADOS: os valores médios da resistência ao cisalhamento em Megapascal foram de: GI = 4,39; GII = 7,11 e GIII = 7,35. Após a descolagem foram realizadas fotografias das áreas de colagem, tanto dos dentes submetidos a testes in vivo quanto in vitro e ampliadas 5x para facilitar a visualização. As imagens obtidas foram analisadas, classificadas de acordo com o IAR e, por meio de gráficos de dispersão, foi verificada a relação entre a resistência ao cisalhamento e este índice. CONCLUSÃO: a média dos ensaios mecânicos realizados in vivo foi estatisticamente menor em relação aos ensaios in vitro. Não houve diferenças na resistência ao cisalhamento in vitro entre o grupo termociclado e o não-termociclado. Não houve relação entre tensão de ruptura e tipo de falha.

Effect of thermal cycling on microleakage between hard chairside relines and denture base acrylic resins

Objectives:Microleakage is a pre-stage of debonding between hard chairside relines and denture base acrylic resins. Therefore, it is important to assess them with regard to the longevity of the relined denture. This study investigated the effect of thermal cycling on the microleakage at the interface of three hard chairside reline resins and three denture base resins.Material and methods:Rectangular bars (12 mm x 3 mm x 3 mm) of Lucitone 550, Acron MC and QC 20 were made and relined with Kooliner, Tokuyama Rebase Fast II and Ufi Gel Hard, Lucitone 550, Acron MC and QC 20 resins. Specimens were divided into one control and two test groups (n = 10). In specimens of the control group, the microleakage was performed after the reline procedure. In Test Group 1, the specimens were stored for 24 h in distilled water at room temperature and in Test Group 2; the specimens were thermal cycled from 5 to 55 degrees C for 5000 cycles with a 30-s dwell time. Subsequently, all specimens were immersed in 50% silver nitrate solutions for 24 h. All specimens were sectioned longitudinally into three fractions and the lateral sections were examined (n = 20). Silver nitrate stain penetration was examined under a stereoscopic lens with x30 magnification, and the images were captured. Leica Qwin image analysis software was used to determine microleakage at the interface of the materials. Data were analysed using the Kruskal-Wallis test at a 95% level of significance.Results:For all cycles, there were no statistically significant differences between thermal cycled and non-thermal cycled groups (p > 0.05).Conclusion:It can be concluded that thermal cycling had no effect on the microleakage.

Bond strength of Epiphany (TM) Sealer combined with different adhesive systems photo-activated with LED and QTH

The Epiphany (TM) Sealer is a new dual-curing resin-based sealer and has been introduced as an alternative to gutta-percha and traditional root canal sealers. The canal filling is claimed to create a seal with the dentinal tubules within the root canal system producing a 'monoblock' effect between the sealer and dentinal tubules. Therefore, considering the possibility to incorporate the others adhesive systems, it is important to study the bond strength of the resulting cement. Forty-eight root mandibular canines were sectioned 8-mm below CEJ. The dentine discs were prepared using a tapered diamond bur and irrigated with 1% NaOCl and 17% EDTA. Previous the application Epiphany (TM) Sealer, the Epiphany (TM) Primer, AdheSE, and One Up Bond F were applied to the root canal walls. The LED and QTH (Quartz Tungsten Halogen) were used to photo-activation during 45 s with power density of 400 and 720 mW/cm(2), respectively. The specimens were performed on a universal testing machine at a cross-head speed of 1 mm/min until bond failure occurred. The force was recorded and the debonding values were used to calculate Push-out bond strength. The analysis of variance (ANOVA) and Tukey's post-hoc tests showed significant statistical differences (P < 0.05) to Epiphany (TM) Sealer/Epiphany (TM) Primer/QTH and EpiphanyTM Sealer/AdheSE/QTH, which had the highest mean values of bond strength. The efficiency of resin-based filling materials are dependent the type of light curing unit used including the power density, the polymerization characteristics of these resin-based filling materials, depending on the primer/adhesive used.

Avaliação da influência dos tipos de tratamento superficial da porcelana glazeada na colagem de braquetes ortodônticos

OBJETIVO: o objetivo deste trabalho foi avaliar a influência do tipo de tratamento superficial da porcelana na resistência adesiva da colagem de braquetes ortodônticos e o modo de fratura após a descolagem. METODOLOGIA:foram confeccionados 80 corpos-de-prova de porcelana, divididos em quatro grupos (n = 18) de acordo com os diferentes tratamentos de superfície: (G1) ponta diamantada; (G2) ponta diamantada e silano; (G3) ácido hidrofluorídrico e (G4) ácido hidrofluorídrico e silano. Após o preparo das superfícies, braquetes Edgewise (Morelli) foram colados com resina (Transbond XT, 3M) e submetidos ao teste de cisalhamento. Os resultados foram avaliados estatisticamente pelo teste de Kruskal-Wallis. RESULTADO: o grupo G1 apresentou uma média de resistência de 3,35, o G2 3,97, o G3 2,56 e o G4 3,10. CONCLUSÃO: constatou-se que não houve diferença estatisticamente significativa na resistência adesiva do braquete entre os tipos de tratamentos estudados (p > 0,05) e os modos de fratura ocorreram, em sua grande maioria, na interface braquete/resina. Este estudo indica que todos os tipos de tratamentos apresentados são eficientes para a colagem.

Influence of ceramic surface conditioning and resin cements on microtensile bond strength to a glass ceramic

Statement of problem. It is not clear how different glass ceramic surface pretreatments influence the bonding capacity of various luting agents to these surfaces.Purpose. The purpose of this study was to evaluate the microtensile bond strength (mu TBS) of 3 resin cements to a lithia disilicate-based ceramic submitted to 2 surface conditioning treatments.Material and methods. Eighteen 5 X 6 X 8-mm ceramic (IPS Empress 2) blocks were fabricated according to manufacturer's instructions and duplicated in composite resin (Tetric Ceram). Ceramic blocks were polished and divided into 2 groups (n=9/treatment): no conditioning (no-conditioning/control), or 5% hydrofluoric acid etching for 20 seconds and silanization for 1 minute (HF + SIL). Ceramic blocks were cemented to the composite resin blocks with I self-adhesive universal resin cement (RelyX Unicem) or 1 of 2 resin-based luting agents (Multilink or Panavia F), according to the manufacturer's instructions. The composite resin-ceramic blocks were stored in humidity at 37 degrees C for 7 days and serially sectioned to produce 25 beam specimens per group with a 1.0-mm(2) cross-sectional area. Specimens were thermal cycled (5000 cycles, 5 degrees C-55 degrees C) and tested in tension at 1 mm/min. Microtensile bond strength data (MPa) were analyzed by 2-way analysis of variance and Tukey multiple comparisons tests (alpha=.05). Fractured specimens were examined with a stereomicroscope (X40) and classified as adhesive, mixed, or cohesive.Results. The surface conditioning factor was significant (HF+SIL > no-conditioning) (P<.0001). Considering the unconditioned groups, the mu TBS of RelyX Unicem was significantly higher (9.6 +/- 1.9) than that of Multilink (6.2 +/- 1.2) and Panavia F (7.4 +/- 1.9). Previous etching and silanization yielded statistically higher mu TBS values for RelyX Unicem (18.8 +/- 3.5) and Multilink (17.4 +/- 3.0) when compared to Panavia F (15.7 +/- 3.8). Spontaneous debonding after thermal cycling was detected when luting agents were applied to untreated ceramic surfaces.Conclusion. Etching and silanization treatments appear to be crucial for resin bonding to a lithia disilicate-based ceramic, regardless of the resin cement used.

The influence of ultrasound on the retention of cast posts cemented with different agents

Aim: The aim of this study was to evaluate the influence of ultrasound during the removal of posts cemented with either zinc phosphate cement, glass ionomer cement or resin cement. Methodology: Eighty-four single-rooted teeth were prepared and after cementation of cast posts, they were randomly divided into six groups of 14. Groups 1, 2 and 3 did not receive ultrasonic vibration, whilst groups 4, 5 and 6 received ultrasonic vibration for 10 min. The force necessary for post removal was determined using a universal testing machine. Results were statistically analysed using ANOVA and Tukey tests (5%). Results: The application of ultrasonic vibration reduced the retention provided by zinc phosphate and glass ionomer cements by 39% and 33%, respectively. Conclusions: A statistically significant reduction in the force necessary to remove posts cemented with zinc phosphate and glass ionomer cements occurred following application of ultrasound. The application of ultrasonic vibration did not influence the retention of cast posts cemented with resin cement.

Shear bond strength of orthodontic brackets bonded using halogen light and light-emitting diode at different debond times

The aim of this in vitro study was to compare the photoactivation effects of QTH (Quartz-Tungsten-Halogen) and LED (Light-Emitting Diode) on the SBS (Shear Bond Strength) of orthodontic brackets at different debond times. Seventy-two bovine lower incisors were randomly divided into two groups according to the photoactivation system used (QTH or LED). The enamel surfaces were conditioned with Transbond self-etching primer, and APC (Adhesive Pre-Coated) brackets were used in all specimens. Group I was cured with QTH for 20 s and Group II with LED for 10 s. Both groups were subdivided according to the different experimental times after bonding (immediately, 24 h and 7 days). The specimens were tested for SBS and the enamel surfaces were analyzed according to the Adhesive Remnant Index (ARI). The statistical analysis included the Tukey's test to evaluate the main effects of photoactivation and debond time on SBS. The Chi-square test was used to compare the ARI values found for each group, and no statistically significant difference was observed. The debond time of 7 days for QTH photoactivation showed statistically greater values of SBS when compared to the immediate and 24 h periods. There was no statistically significant difference between the QTH and LED groups immediately and after the 24 h period. In conclusion, bonding orthodontic brackets with LED photoactivation for 10 s is suggested because it requires a reduced clinical chair time.

In vitro lingual bracket evaluation of indirect bonding with plasma arc, LED and halogen light

Authors - Magno AFF, Martins RP, Vaz LG, Martins LP Objectives - Evaluate the shear bond strength (SBS) and the adhesive remnant index (ARI) of indirect bonded lingual brackets using xenon plasma arc light, light-emitting diode (LED) and conventional quartz-tungsten-halogen light. Material and Methods - Lingual brackets were bonded indirectly to 60 premolars divided to three groups according to the curing light used: Group 1, plasma arc for 6 s; Group 2, LED for 10 s; and Group 3, halogen light for 40 s. After bonding, the specimens were subjected to a shear force until debonding. The debonding pattern was assessed and classified according to the ARI scores. The mean shear bond strengths were accessed by anova followed by the Student-Newman-Keuls test for multiple comparisons. ARI scores were assessed using the chi-square test. Results - The three groups showed significant differences (p < 0.001), with the averages of group 1 < group 2 < group 3. Groups showed no differences regarding ARI scores. Conclusion - Bonding lingual brackets indirectly with plasma arc, during 60% of the time used for the LED, produced lower SBS than obtained with the latter. Using LED during 25% of the time of the halogen light produced lower SBS than obtained with the latter. These differences did not influence the debonding pattern and are clinically acceptable according to the literature. © 2010 John Wiley & Sons A/S.

Effectiveness of rotary or manual techniques for removing a 6-year-old filling material

The aim of this study was to evaluate the effectiveness of manual and rotary instrumentation techniques for removing root fillings after different storage times. Twenty-four canals from palatal roots of human maxillary molars were instrumented and filled with gutta-percha and zinc-oxide eugenol-based sealer (Endofill), and were stored in saline for 6 years. Non-aged control specimens were treated in the same manner and stored for 1 week. All canals were retreated using hand files or ProTaper Universal NiTi rotary system. Radiographs were taken to determine the amount of remaining material in the canals. The roots were vertically split, the halves were examined with a clinical microscope and the obtained images were digitized. The images were evaluated with AutoCAD software and the percentage of residual material was calculated. Data were analyzed with two-way ANOVA and Tukey's test at 5% significance level. There was no statistically significant differences (p>0.05) between the manual and rotary techniques for filling material removal regardless the ageing effect on endodontic sealers. When only the age of the filling material was analyzed microscopically, non-aged fillings that remained on the middle third of the canals presented a higher percentage of material remaining (p<0.05) compared to the aged sealers and to the other thirds of the roots. The apical third showed a higher percentage of residual filling material in both radiographic and microscopic analysis when compared to the other root thirds. In conclusion, all canals presented residual filling material after endodontic retreatment procedures. Microscopic analysis was more effective than radiographs for detection of residual filling material.

Effect of surface treatments on the bond strength of a resin cement to commercially pure titanium

Investigation of the effectiveness of surface treatments that promote a strong bond strength of resin cements to metals can contribute significantly to the longevity of metal-ceramic restorations. This study evaluated the effect of surface treatments on the shear bond strength (SBS) of a resin cement to commercially pure titanium (CP Ti). Ninety cast CP Ti discs were divided into 3 groups (n=30), which received one of the following airborne-particle abrasion conditions: (1) 50 μm Al2O3 particles; (2) 30 μm silica-modified Al2O3 particles (Cojet Sand); (3) 110 μm silica-modified Al2O3 particles (Rocatec). For each airborne-particle abrasion condition, the following post-airborne-particle abrasion treatments were used (n=10): (1) none; (2) adhesive Adper Single Bond 2; (3) silane RelyX Ceramic Primer. RelyX ARC resin cement was bonded to CP Ti surfaces. All specimens were thermally cycled before being tested in shear mode. Failure mode was determined. The best association was Rocatec plus silane. All groups showed 100% adhesive failure. There were combinations that promote higher SBS than the protocol recommended by the manufacturer of RelyX ARC.