Eficácia do cimento de ionômero de vidro como selante oclusal sobre a paralisação de lesões cariosas em dentina

Dental caries consists in a multifactorial and dynamic process. The knowledge of the ionic interactions among dental tissues and dental biofilm make possible its understanding as a process that can be stopped. Recently, the use of sealants have lost its function as preventive agent and passed to be argued as a possible therapeutical agent. This happens by hindering the substratum flow to the lesion inner and, therefore, controls the advance of the process. This study aimed to evaluate glass ionomer cement as a not invasive technique of treatment in occlusal caries without clinical cavitation, but with dentinal involvement. The research was accomplished using a controlled clinical trial with two groups (experimental and control) in 38 subjects (8-18 years) with 51 molars. The teeth of the experimental group were sealed with glass ionomer cement (Vidrion-R, S.S.White, Juiz de Fora, Brazil) and the molars control did not suffer intervention. The experimental group was followed by a year and the control by 8 months due the progression of the carious injury. Both groups were reevaluated to each 4 months with the use of clinical, radiographic and laser fluorescence (DIAGNOdent®) examination. The analysis of the clinical evaluation did not observe a significant difference between experimental and control groups. However, analysis with radiographic and laser fluorescence (DIAGNOdent®) examination observed a significant difference (p> 0,05) between groups, demonstrating a wors condition to the group without intervention. The results suggest that glass ionomer cement as sealant can be efficient to paralyze dentinal caries without clinical cavitation

Periodontal tissue response to coverage of root cavities restored with resin materials: A histomorphometric study in dogs

Background: the purpose of this study was to histomorphometrically evaluate the response of periodontal tissues covering Class V resin restorations in dogs.Methods: After raising a mucoperiosteal flap, bony defects measuring 5 x 5 mm were created on the buccal aspect of the canines of five dogs followed by cavity preparations on the root surface measuring 3 x 3 x 1 mm. Before repositioning the flap to cover the bone defect, the cavities were restored with composite resin (CR) or resin-modified glass ionomer cement (RMGIC) or were left unrestored as control (C). The dogs were euthanized 90 days after surgery. Specimens comprising the tooth and periodontal tissues were removed, processed routinely, cut into longitudinal serial sections in the bucco-lingual direction, and stained with hematoxylin and eosin (H&E) or Masson's trichrome. The most central sections were selected for histomorphometric analysis.Results: Histomorphometric analysis revealed apical migration of epithelial tissue onto the restorative materials (RMGIC and CR). The C group presented significantly longer connective tissue attachment (P < 0.05) than the RMGIC and CR groups and significantly higher bone regeneration (P < 0.05) compared to the RMGIC group. Histologically, the cervical third (CT) of all groups had the most marked chronic inflammatory infiltrate.Conclusions: Within the limits of this study, it can be concluded that the restorative materials used exhibit biocompatibility; however, both materials interfered with the development of new bone and the connective tissue attachment process.

Effect of pH variations in a cycling model on the properties of restorative materials

This study evaluated the effect of cycling various pH demineralizing solutions on the surface hardness, fluoride release and surface properties of restorative materials (Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom and Fluorofil). Thirty specimens of each material were made and the surface hardness measured. The specimens were randomized into five groups according to the pH (4.3; 4.6; 5.0; 5.5 and 6.2) of the demineralizing solution. The specimens were submitted to pH-cycling for 15 days. The specimens remained in the demineralizing solution for six hours and in the remineralizing solution for 18 hours. Then, the surface hardness (SH) was remeasured and the surface properties were assessed. Fluoride release was determined daily. Data from SH and the percentage of alteration in surface hardness were analyzed by analysis of variance (p < 0.05); the Kruskal-Wallis test was performed for the fluoride release results. When hardness was compared, the variation in pH led to a positive correlation for glass ionomer cements and a negative correlation for fluoride release. For polyacid-modified resin composites, a negative correlation was found with regards to fluoride release; no significant correlation was observed for hardness. Surface properties were influenced: an acidic pH led to a greater alteration, except for polyacid-modified resin composites. The pH of the demineralizing solution influenced fluoride release from the tested materials. The pH variation altered hardness and surface properties of glass ionomer cements but did not influence polyacid-modified resin composites.

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.

In Vitro Evaluation of Surface Roughness and Microhardness of Restorative Materials Submitted to Erosive Challenges

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

Effect of erosive pH cycling on different restorative materials and on enamel restored with these materials

This in vitro study evaluated the effect of erosive pH cycling on the percentage of surface micro-hardness change (%SMHC) and wear of different restorative materials and bovine enamel restored with these materials. Eighty enamel specimens were randomly divided into eight groups according to the restorative materials and immersion media used: GI/GV-resin-modifled glass-ionomer, GII/GVI-conventional glass-ionomer, GIII/GVII-resin composite and GIV/GVIII-amalgam. Over a period of seven days, groups GI to GIV were immersed in a cola drink (ERO) for 5 minutes, 3x/day and kept in artificial saliva between erosive cycles. Groups GV to GVIII were immersed in artificial saliva (SAL) throughout the entire experimental period (control). Data were tested for significant differences using ANOVA and Tukey's tests (p < 0.05). For %SMHC, considering the restorative materials, no significant differences were detected among the materials and immersion media. Mean wear was higher for the resin modified glass ionomer cement when compared to conventional cement, but those materials did not significantly differ from the others. For enamel analyses, erosive pH cycling promoted higher wear and %SMHC compared to saliva. There were no significant differences in wear and %SMHC of enamel around the different restorative materials, regardless of the distance from the restorative material (50, 150 or 300 mu m). In conclusion, there were only subtle differences among the materials, and these differences were not able to protect the surrounding enamel from erosion.

Biocompatibility of resin-based materials used as pulp-capping agents

Aim To evaluate and compare the response of pulps of rats capped with resin-modified glass-ionomer cement (RMGIC) or self-etching adhesive system.Methodology Class I cavities were prepared on the occlusal surface of 54 maxillary first molars of 27 rats. Pulp exposure was performed on the cavity floor. The following resin-based materials were applied as pulp-capping agents: G1, Clearfil Liner Bond 2V (CLB 2V; Kuraray Co., Japan); G2, Vitrebond (VIT; 3M/ESPE, USA). In group 3 (control group), a calcium hydroxide/saline paste (CH; Labsynth, Brazil) was used. The cavities were restored with amalgam. After 7, 30 and 60 days, the animals were sacrificed and the jaws were processed for microscopic evaluation.Results Despite the inflammatory response caused by the experimental and the control materials at 7 days, pulpal healing associated with calcified barrier formation was observed at 60 days following the pulp therapy. Both resin-based materials promoted a large zone of cell-rich fibrodentine matrix deposition on the pulp horn related to the pulp exposure site, which was larger to VIT than to CLB 2V specimens. Tertiary dentine underneath the fibrodentine matrix was deposited by a layer of elongated pulpal cells. The remaining pulpal tissue exhibited normal histological characteristics. In the control group, healing and dentine-bridge formation was observed at 30 days. Pulpal breakdown occurred only when bacterial infection occurred.Conclusion Both experimental pulp-capping agents allowed pulpal healing characterized by cell-rich fibrodentine and tertiary dentine deposition as well as calcified barrier formation.

Utilization of autogenous bone, bioactive glasses, and calcium phosphate cement in surgical mandibular bone defects in Cebus apella monkeys

Purpose: the purpose of the present study was to evaluate the histologic results of bone cavities that were surgically created in the mandibles of Cebus apella monkeys and filled with autogenous bone, PerioGlas, FillerBone, or Bone Source. Materials and Methods: Surgical cavities 5 mm in diameter were prepared through both mandibular cortices in the mandibular angle region. The cavities were randomly filled, and the animals were divided into groups according to the material employed: Group 1 cavities were filled with autogenous corticocancellous bone; group 2 cavities were filled with calcium phosphate cement (BoneSource); and group 3 and group 4 cavities were filled with bioactive glass (FillerBone and PerioGlas, respectively). After 180 days the animals were sacrificed, and specimens were prepared following routine laboratory procedures for hematoxylin/eosin staining and histologic evaluation. Results: the histologic analysis showed that autogenous bone allowed total repair of the bone defects; bioactive glasses (FillerBone and PerioGlas) allowed total repair of the defects with intimate contact of the remaining granules and newly formed bone; and the cavities filled with calcium phosphate cement (BoneSource) were generally filled by connective fibrous tissue, and the material was almost totally resorbed. Discussion: the autogenous bone, FillerBone, and PerioGlas provided results similar to those in the current literature, showing that autogenous bone is the best Choice for filling critical-size defects. Synthetic implanted materials demonstrated biocompatibility, but the bioglasses demonstrated osteoconductive activity that did not occur with calcium phosphate (BoneSource). Conclusion: According to the methodology used in this study, it can be concluded that the utilization of autogenous bone and bioactive glasses permitted the repair of surgically created critical-size defects by newly formed bone; the synthetic implanted materials demonstrated biocompatibility, and the bioactive glasses demonstrated osteoconductive activity. The PerioGlas was mostly resorbed and replaced by bone and the remaining granules were in close contact with bone; the FillerBone showed many granules in contact with the newly formed bone; BoneSource did not permit repair of the critical-size defects, and the defects were generally filled by connective fibrous tissue.

Tissue response to experimental dental cements prepared from a modified power glass composition

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

THE EFFECT of DIFFERENT SURFACE TREATMENTS on THE SHEAR BOND STRENGTH of LUTING CEMENTS TO TITANIUM

Statement of problem. Although titanium presents attractive physical and mechanical properties, there is a need for improving the bond at the titanium/luting cement interface for the longevity of metal ceramic restorations.Purpose. The purpose of this study was to evaluate the effect of surface treatments on the shear bond strength (SBS) of resin-modified glass ionomer and resin cements to commercially pure titanium (CP Ti).Material and methods. Two hundred and forty CP Ti cast disks (9.0 x 3.0 mm) were divided into 8 surface treatment groups (n=30): 1) 50 mu m Al2O3 particles; 2) 120 mu m Al2O3 particles; 3) 250 mu m Al2O3 particles; 4) 50 mu m Al2O3 particles + silane (RelyX Ceramic Primer); 5) 120 mu m Al2O3 particles + silane; 6) 250 mu m Al2O3 particles + silane; 7) 30 mu m silica-modified Al2O3 particles (Cojet Sand) + silane; and 8) 120 mu m Al2O3 particles, followed by 110 mu m silica-modified Al2O3 particles (Rocatec). The luting cements 1) RelyX Luting 2; 2) RelyX ARC; or 3) RelyX U100 were applied to the treated CP Ti surfaces (n=10). Shear bond strength (SBS) was tested after thermal cycling (5000 cycles, 5 degrees C to 55 degrees C). Data were analyzed by 2-way analysis of variance (ANOVA) and the Tukey HSD post hoc test (alpha=.05). Failure mode was determined with a stereomicroscope (x20).Results. The surface treatments, cements, and their interaction significantly affected the SBS (P<.001). RelyX Luting 2 and RelyX U100 exhibited similar behavior for all surface treatments. For both cements, only the group abraded with 50 mu m Al2O3 particles had lower SBS than the other groups (P<.05). For RelyX ARC, regardless of silane application, abrasion with 50 mu m Al2O3 particles resulted in significantly lower SBS than abrasion with 120 mu m and 250 mu m particles, which exhibited statistically similar SBS values to each other. Rocatec + silane promoted the highest SBS for RelyX ARC. RelyX U100 presented the highest SBS mean values (P<.001). All groups showed a predominance of adhesive failure mode.Conclusions. The adhesive capability of RelyX Luting 2 and RelyX U100 on the SBS was decisive, while for RelyX ARC, mechanical and chemical factors were more influential. (J Prosthet Dent 2012;108:370-376)

Bond strength of adhesive restorations to Er : YAG laser-treated dentin

Background and Objective: evaluate the adhesion of adhesive restorations with and without a base of resin-modified glass-ionomer cement (RMGIC) to dentin irradiated with Er:YAG laser.Study Design/Materials and Methods: Twenty-four human molar teeth were divided into 6 groups (n=4): G1) 37% Phosphoric acid (PA) + Adhesive system (Ad) + Composite resin (CR); G2) RMGIC + CR; G3) Laser (60mJ-5Hz-20s) + PA + Ad + CR; G4) Laser (60 mJ-5 Hz-20 s) + RMGIC + CR; G5) Laser (100mJ-5Hz-20s) + PA + Ad + CR; G6) Laser (100mJ-5Hz-20s) + RMGIC + CR. Teeth were prepared, restored and cut into specimens, according to the treatment proposed and to methodology for microtensile test. Data were submitted to ANOVA and Tukey statistical tests (alpha=5%).Results:. The mean values for adhesion (MPa) and standard deviation (+/- SD) were: G1) 26.30(+/- 4.50), G2) 5.34(+/- 2.87), G3) 21.16(+/- 6.01), G4) 5.22(+/- 1.52), G5) 22.23(+/- 4.98), G6) 5.25(+/- 3.08).Conclusion: the use of Er:YAG laser did not influence on the restorations adhesion.

Occlusal caries prevention in high and low risk schoolchildren. A clinical trial

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

SEALING ABILITY of CASTOR OIL POLYMER AS A ROOT-END FILLING MATERIAL

Objective: The purpose of this study was to evaluate the sealing ability of castor oil polymer (COP), mineral trioxide aggregate (MTA) and glass ionomer cement (GIC) as root-end filling materials. Forty-five single-rooted human teeth were cleaned and prepared using a step-back technique. The apical third of each root was resected perpendicularly to the long axis direction. All teeth were obturated with gutta-percha and an endodontic sealer. After, a root-end cavity with 1.25-mm depth was prepared using a diamond bur. The specimens were randomly divided into three experimental groups (n = 15), according to the root-end filling material used: G1) COP; G2) MTA; G3) GIC. The external surfaces of the specimens were covered with epoxy adhesive, except the root-end filling. The teeth were immersed in rhodamine B dye for 24 hours. Then, the roots were sectioned longitudinally and the linear dye penetration at the dentin/material interface was determined using a stereomicroscope. ANOVA and Tukey's tests were used to compare the three groups. The G1 group (COP) presented smaller dye penetration, statistically different than the G2 (MTA) and G3 (GIC) groups (p < 0.05). No statistically significant difference in microleakage was observed between G2 and G3 groups (p > 0.05). The results of this study indicate that the COP presented efficient sealing ability when used as a root-end filling material showing results significantly better than MTA and GIC.

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)

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.