Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Effect of caries preventive measures directed to expectant mothers on caries experience in their children

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

Caracterização de cimento odontológico obtido a partir de um vidro preparado pelo método dos precursores poliméricos

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

Uso das técnicas de infravermelho e de ressonância magnética nuclear na caracterização da reação ácido-base de um cimento odontológico experimental

Glass ionomer cements (GICs) are products of the acid-base setting reaction between an finely fluoro-alumino silicate glass powder and poly(acrylic acid) in aqueous solution. The sol gel method is an adequate route of preparation of the glasses used to obtain the GICs. The objective of this paper was to compare two powders: a commercial and an experimental and to investigate the structural changes during hardening of the cements by FTIR and Al MAS NMR. These analyses showed that the experimental glass powder reacted with organic acid to form the GICs and it is a promising material to manufacture dental cements.

Efeito cariostático de restaurações adesivas em superfícies radiculares: estudo in vitro

Materiais restauradores que liberam íons flúor e/ou promovem adesão à estrutura dental têm sido relacionados com a inibição do desenvolvimento de lesões de cárie adjacentes às restaurações. A hipótese testada neste estudo foi a de que o uso de resina composta/sistema adesivo tem efeito cariostático semelhante a um material adesivo que libera íons flúor - cimento de ionômero de vidro - sobre a superfície radicular adjacente às restaurações. Foram utilizadas 20 raízes de terceiros molares humanos extraídos, embutidas em resina de poliestireno e planificadas. Cavidades padronizadas foram preparadas e restauradas aleatoriamente com (a) Chelon-Fil (Espe) ou (b) Z100/SingleBond (3M). Valores iniciais (KHNi) de microdureza superficial Knoop da dentina foram obtidos a 100, 200 e 300 mim da margem oclusal das restaurações. Uma área de 2,0 mm ao redor da restauração foi delimitada e submetida à indução de cárie artificial. Obtiveram-se, então, os valores finais (KHNf) de microdureza, nas mesmas condições e localizações da leitura inicial. As diferenças entre KHNi e KHNf foram consideradas para a análise estatística. As medianas de KHNi - KHNf nas distâncias de 100, 200 e 300 mim foram para (a): -3,8; -0,3; -1,0; e para (b): 3,3; 2,5; 1,7. O teste de Kruskal-Wallis não evidenciou diferença significativa entre as distâncias dentro de cada grupo. Às distâncias de 200 e 300 mim, não houve diferença significativa entre os materiais avaliados. À distância de 100 mim, (a) diferiu significativamente de (b) (p < 0,05). Sob as condições deste estudo, o cimento de ionômero de vidro apresentou maior potencial cariostático que a resina composta com sistema adesivo dentinário.

Cimentos endodônticos: análise morfológica imediata e após seis meses utilizando microscopia de força atômica

O objetivo deste trabalho foi analisar a morfologia dos cimentos Sealapex, Apexit, Sealer 26 (cimentos a base de hidróxido de cálcio) e Ketac Endo (cimento de ionômero de vidro), através da microscopia de força atômica, verificando-se as características de suas partículas após a obturação dos canais radiculares e após um período de seis meses de contato com o plasma sanguíneo humano. Utilizaram-se 16 dentes unirradiculares humanos extraídos e incluídos em blocos de resina após o preparo biomecânico. As raízes foram divididas em quatro grupos de quatro raízes cada e os canais radiculares obturados pela técnica de condensação lateral passiva com os cimentos em estudo. Verificou-se que o cimento Apexit foi o que mais sofreu desintegração após seis meses de imersão em plasma sanguíneo humano, seguido pelo Ketac Endo e Sealapex. Dentre todos os cimentos estudados, o Sealer 26 mostrou-se o mais uniforme e com a menor desintegração.

Rugosidade e pigmentação superficial de materiais ionoméricos

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

Avaliação clínica de vinte e quatro meses do Fluroshield e do Vitremer utilizados como selante de fossas e fissuras

Avaliou-se o desempenho de dois materiais utilizados como selante oclusal (Fluroshield e Vitremer). Foram selados 46 pré-molares, superiores e/ou inferiores, sem sinais clínicos de lesões de cárie, sendo que 23 dentes foram selados com Vitremer e 23 com Fluroshield. Após seis, doze e vinte e quatro meses de acompanhamento, observou-se que o Vitremer apresentou uma retenção total de 91,30%, 91,30% e 82,60%, enquanto o Fluroshield apresentou 100% de retenção total nos três intervalos de tempo. Ambos os materiais impediram o desenvolvimento de lesões de cárie, independente de sua retenção e períodos avaliados.

Effect of rotary or manual instrumentation, with or without a calcium hydroxide/1% chlorhexidine intracanal dressing, on the healing of experimentally induced chronic periapical lesions

Objective. To evaluate the healing of experimentally induced chronic periapical lesions in dogs at 30, 75, and 120 days after root canal instrumentation with rotary NiTi files or manual K-files, with or without a calcium hydroxide/1% chlorhexidine paste intracanal dressing.Study design. The second, third, and fourth mandibular premolars and the second and third maxillary premolars of 5 dogs (12 to 18 months of age, weighing 8 to 15 kg) were selected for treatment (a total of 82 root canals). After pulp removal, the root canals were left exposed to the oral cavity for 7 days to allow microbial contamination, after which the root canals were sealed with ZOE cement until periapical lesions were confirmed with radiography. Group I and II teeth were instrumented with manual K-files using the crown-down technique. In group III and IV teeth, NiTi rotary files were used. The apical delta was perforated by using #20 to #30 K-files at the length of the tooth, thus creating a standardized apical opening. The apical stop was enlarged to size 70, with 2.5% sodium hypochlorite irrigation at each file change. Teeth in groups II and IV were dressed with calcium hydroxide (Ca(OH)(2))/1% chlorhexidine (CHX) paste for 15 days before root filling. Group I and III teeth did not receive an intracanal dressing. The access openings of the teeth were permanently restored with silver amalgam condensed on a glass ionomer cement base. Pairs of standardized periapical radiographs were taken at the beginning of the treatment (0 days) and at 30, 75, and 120 days after filling.Results. There was no significant difference in the rate of radiographic healing of the periapical lesions between manual and rotary instrumentation. Radiographs taken at 120 days showed that the treatment with Ca(OH)(2)/1% CHX paste resulted in a significant reduction in mean size of the periapical lesions in comparison to single-session treatment. These findings were also true for histologic observations.Conclusion. The findings support the hypothesis that, regardless of the instrumentation technique (manual or rotary), the use of an intracanal dressing is important in the endodontic treatment of dog's teeth with experimentally induced chronic periapical lesions.

Reactionary dentinogenesis after applying restorative materials and bioactive dentin matrix molecules as liners in deep cavities prepared in nonhuman primate teeth

Objective: the aim of this in vivo study was to evaluate the response of the pulp-dentin complex following application of resin-modified glass-ionomer cement, calcium hydroxide hard-setting cement and EDTA-soluble preparation of dentine matrix proteins (ESDP) in deep cavities prepared in non-human primate teeth. Methods: Eighteen deep Class V buccal cavities were prepared in premolars of four capuccin monkeys. In Groups 1 and 2, the cavity floor was lined with ESDP or a resin-modified glass-ionomer cement (Vitrebond - 3M ESPE), respectively. In Group 3 (control), the cavity was lined with a hard setting calcium hydroxide cement (Dycal - Dentsply). The cavities were subsequently filled with amalgam. After 6 months, the animals were sacrificed and the teeth were prepared for microscopic assessment. Six-micron thick serial sections were stained with H/E, Masson's trichrome and Brown & Brenn techniques. Results: No inflammatory pulpal response was observed for all experimental and control Groups. However, the amount of reactionary dentin deposition differed between groups in the rank order ESDP (Group 1) > calcium hydroxide (Group 3) > resin-modified glass-ionomer (Group 2). These differences were statistically significant. Conclusions: All materials were biocompatible when applied in deep cavities. ESDP stimulated higher deposition of reactionary dentin matrix than Vitrebond and Dycal.

Sealing evaluation of the cervical base in intracoronal bleaching

Discoloration of non-vital teeth is an esthetic deficiency frequently requiring bleaching treatment. The purpose of this study was to evaluate in vitro the cervical base efficacy in order to prevent or to minimize the leakage along the root canal filling and into the dentinal tubules. Thirty-eight extracted single-root human teeth were used, which were biomechanically prepared, filled, and divided into three experimental groups: G1, a cervical base was applied (3 mm of thickness) below the cemento-enamel junction, with resin-modified glass-ionomer cement (Vitremer); G2, the base was done with glass-ionomer cement (Vidrion R); and G3 (Control), did not receive any material as base. A mixture of sodium perborate and hydrogen peroxide 30% was placed inside the pulp chamber for 3 days, and the access opening was sealed with Cimpat. This procedure was repeated thrice. Soon after this, a paste of calcium hydroxide was inserted into the pulp chamber for 14 days. All teeth were covered with two layers of sticky wax, except the access opening, and immersed in blue India Ink for 5 days. The results did not show statistically significant differences between the three groups concerning the leakage inside the dentinal tubules. Regarding the apical direction, a statistical difference (ANOVA P < 0.05) was observed among the experimental group G1 and control group G3. No statistically significant difference was observed between G2 and G3 groups. Therefore, the placement of a cervical base before internal bleaching procedures is still recommended.

Radiopacity of esthetic restorative materials compared with human tooth structure

Purpose : To compare the radiopacity of 13 restorative materials, (a conventional glass-ionomer cement, three resin-modified glass-ionomer cements, six polyacid-modified resin-based composites, and three resin-based composites) to sound tooth structure. Materials and Methods: 315 specimens were made of the restorative materials (n= 21), of 2 min height and 4.1 mm diameter. Radiographs were taken of the specimens, together with the tooth structure sample and an aluminum step wedge. The radiopacity values of each specimen were taken using a transmission densitometer. Results: ANOVA and Tukey's test (95% level of confidence) revealed that, except for a resin-based composite, a polyacid-modified resin-based composite, a resin-modified glass-ionomer cement and the conventional glass-ionomer cement, all the evaluated restorative materials were more radiopaque than the tooth structure.

Vertical marginal discrepancy of ceramic copings with different ceramic materials finish lines and luting agents: An in vitro evaluation

Statement of problem. Prosthetic restorations that fit poorly may affect periodontal health and occlusion. Studies that have evaluated the accuracy of fit of ceramic restorations before and after cementation assessed primarily intracoronal restorations.Purpose. This in vitro study evaluated the effect of different finish lines, ceramic manufacturing techniques, and luting agents on the vertical discrepancy of ceramic copings.Material and methods. Two stainless steel molars were prepared for complete crowns with 2 different finish lines (heavy chamfer and rounded shoulder); each molar was duplicated to fabricate 90 copings. A total of 180 copings generated 18 groups (n=10 for each finish line-coping material-luting agent combination). Luting agents tested included zinc phosphate, resin-modified glass ionomer (Fuji Plus), and resin composite cements (Panavia F). A metal frame was developed on which to screw the stainless steel model and a ceramic coping; the distance (mum) between 2 predetermined points was measured before and after cementation by a profile projector under a torquing force. A 4-way ANOVA with repeated measurements was performed to assess the influence of each factor in the vertical marginal discrepancy: 3 between-coping factors (finish line-coping material-luting agent) and 1 within-coping factor (before and after cementation) (alpha=.05).Results. Procera copings presented the lowest mean values (P<.05) of vertical marginal discrepancy before and after cementation (25/44 mum) when compared to Empress 2 (68/110 mum) and InCeram Alumina copings (57/117 mum), regardless of any combinations among all finish lines and luting agents tested.Conclusion. Considering each factor separately, the ceramic manufacturing technique appeared to be the most important factor tested for the definitive vertical discrepancy of all-ceramic copings, with lower mean values for Procera copings.

Penetration of 38% hydrogen peroxide into the pulp chamber in bovine and human teeth submitted to office bleach technique

This study evaluated the pulp chamber penetration of peroxide bleaching agent in human and bovine teeth after office bleach technique. All the teeth were sectioned 3 mm apical of the cement-enamel junction and were divided into 2 groups, A (70 third human molars) and B (70 bovine lateral incisors), that were subdivided into A1 and B1 restored by using composite resin, A2 and B2 by using glass ionomer cement, and A3 and B3 by using resin-modified glass ionomer cement; A4, A5, B4, and B5 were not restored. Acetate buffer was placed in the pulp chamber, and the bleaching agent was applied for 40 minutes as follows: A1-A4 and B1-B4, 38% hydrogen peroxide exposure and A5 and B5, immersion into distilled water. The buffer solution was transferred to a glass tube in which leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to analysis of variance and Dunnett, Kruskal-Wallis, and Tukey tests (5%). A higher level of hydrogen peroxide penetrated into the pulp chamber in resin-modified glass ionomer cements in bovine (0.79 +/- 0.61 mu g) and human (2.27 +/- 0.41 mu g) groups. The bleaching agent penetration into the pulp chamber was higher in human teeth for any experimental situation. The penetration of the hydrogen peroxide depends on restorative materials, and under the conditions of this study human teeth are more susceptible to penetration of bleaching agent into the pulp chamber than bovine teeth.

The influence of cervical finish line, internal relief, and cement type on the cervical adaptation of metal crowns

Objective: the aim of this investigation was to evaluate the cervical adaptation of metal crowns under several conditions, namely (1) variations in the cervical finish line of the preparation, (2) application of internal relief inside the crowns, and (3) cementation using different luting materials. Method and Materials: One hundred eighty stainless-steel master dies were prepared simulating full crown preparations: 60 in chamfer (CH), 60 in 135-degree shoulder (OB), and 60 in rounded shoulder (OR). The finish lines were machined at approximate dimensions of a molar tooth preparation (height: 5.5 mm; cervical diameter: 8 mm; occlusal diameter: 6.4 mm; taper degree: 6; and cervical finish line width: 0.8 mm). One hundred eighty corresponding copings with the same finish lines were fabricated. A 30-mu m internal relief was machined 0.5 mm above the cervical finish line in 90 of these copings. The fit of the die and the coping was measured from all specimens (L0) prior to cementation using an optical microscope. After manipulation of the 3 types of cements (zinc phosphate, glass-ionomer, and resin cement), the coping was luted on the corresponding standard master die under 5-kgf loading for 4 minutes. Vertical discrepancy was again measured (L1), and the difference between L1 and L0 indicated the cervical adaptation. Results: Significant influence of the finish line, cement type, and internal relief was observed on the cervical adaptation (P < .001). The CH type of cervical finish line resulted in the best cervical adaptation of the metal crowns regardless of the cement type either with or without internal relief (36.6 +/- 3 to 100.8 +/- 4 mu m) (3-way analysis of variance and Tukey's test, alpha = .05). The use of glass-ionomer cement resulted in the least cervical discrepancy (36.6 +/- 3 to 115 +/- 4 mu m) than those of other cements (45.2 +/- 4 to 130.3 +/- 2 mu m) in all conditions. Conclusion: the best cervical adaptation was achieved with the chamfer type of finish line. The internal relief improved the marginal adaptation significantly, and the glass-ionomer cement led to the best cervical adaptation, followed by zinc phosphate and resin cement.