Impact of Quantity of Resin, C-factor, and Geometry on Resin Composite Polymerization Shrinkage Stress in Class V Restorations

Objective: This study evaluated the effect of quantity of resin composite, C-factor, and geometry in Class V restorations on shrinkage stress after bulk fill insertion of resin using two-dimensional finite element analysis.Methods: An image of a buccolingual longitudinal plane in the middle of an upper first premolar and supporting tissues was used for modeling 10 groups: cylindrical cavity, erosion, and abfraction lesions with the same C-factor (1.57), a second cylindrical cavity and abfraction lesion with the same quantity of resin (QR) as the erosion lesion, and then all repeated with a bevel on the occlusal cavosurface angle. The 10 groups were imported into Ansys 13.0 for two-dimensional finite element analysis. The mesh was built with 30,000 triangle and square elements of 0.1 mm in length for all the models. All materials were considered isotropic, homogeneous, elastic, and linear, and the resin composite shrinkage was simulated by thermal analogy. The maximum principal (MPS) and von Mises stresses (VMS) were analyzed for comparing the behavior of the groups.Results: Different values of angles for the cavosurface margin in enamel and dentin were obtained for all groups and the higher the angle, the lower the stress concentration. When the groups with the same C-factor and QR were compared, the erosion shape cavity showed the highest MPS and VMS values, and abfraction shape, the lowest. A cavosurface bevel decreased the stress values on the occlusal margin. The geometry factor overcame the effects of C-factor and QR in some situations.Conclusion: Within the limitations of the current methodology, it is possible to conclude that the combination of all variables studied influences the stress, but the geometry is the most important factor to be considered by the operator.

Two-year Clinical Performance of Self-etching Adhesive Systems in Composite Restorations of Anterior Teeth

Objective: The aim of this study was to evaluate the two-year clinical performance of Class III, IV, and V composite restorations using a two-step etch-and-rinse adhesive system (2-ERA) and three one-step self-etching adhesive systems (1-SEAs).Material and Methods: Two hundred Class III, IV, and V composite restorations were placed into 50 patients. Each patient received four composite restorations (Amaris, Voco), and these restorations were bonded with one of three 1-SEAs (Futurabond M, Voco; Clearfil S3 Bond, Kuraray; and Optibond All-in-One, Kerr) or one 2-ERA (Adper Single Bond 2/3M ESPE). The four adhesive systems were evaluated at baseline and after 24 months using the following criteria: restoration retention, marginal integrity, marginal discoloration, caries occurrence, postoperative sensitivity and preservation of tooth vitality. After two years, 162 restorations were evaluated in 41 patients. Data were analyzed using the chi(2) test (p<0.05).Results: There were no statistically significant differences between the 2-ERA and the 1-SEAs regarding the evaluated parameters (p>0.05).Conclusion: The 1-SEAs showed good clinical performance at the end of 24 months.

Influence of Nd:YAG Laser on the Bond Strength of Self-etching and Conventional Adhesive Systems to Dental Hard Tissues

Purpose: The aim of this study was to investigate the influence of Nd:YAG laser on the shear bond strength to enamel and dentin of total and self-etch adhesives when the laser was applied over the adhesives, before they were photopolymerized, in an attempt to create a new bonding layer by dentin-adhesive melting.Material and Methods: One-hundred twenty bovine incisors were ground to obtain flat surfaces. Specimens were divided into two substrate groups (n=60): substrate E (enamel) and substrate D (dentin). Each substrate group was subdivided into four groups (n=15), according to the surface treatment accomplished: X (Xeno III self-etching adhesive, control), XL (Xeno III + laser Nd:YAG irradiation at 140 mJ/10 Hz for 60 seconds + photopolymerization, experimental), S (acid etching + Single Bond conventional adhesive, Control), and SL (acid etching + Single Bond + laser Nd:YAG at 140 mJ/10 Hz for 60 seconds + photopolymerization, experimental). The bonding area was delimited with 3-mm-diameter adhesive tape for the bonding procedures. Cylinders of composite were fabricated on the bonding area using a Teflon matrix. The teeth were stored in water at 37 degrees C/48 h and submitted to shear testing at a crosshead speed of 0.5 mm/min in a universal testing machine. Results were analyzed with three-way analysis of variance (ANOVA; substrate, adhesive, and treatment) and Tukey tests (alpha=0.05). ANOVA revealed significant differences for the substrate, adhesive system, and type of treatment: lased or unlased (p<0.05). The mean shear bond strength values (MPa) for the enamel groups were X=20.2 +/- 5.61, XL=23.6 +/- 4.92, S=20.8 +/- 4.55, SL=22.1 +/- 5.14 and for the dentin groups were X=14.1 +/- 7.51, XL=22.2 +/- 6.45, S=11.2 +/- 5.77, SL=15.9 +/- 3.61. For dentin, Xeno III self-etch adhesive showed significantly higher shear bond strength compared with Single Bond total-etch adhesive; Nd:YAG laser irradiation showed significantly higher shear bond strength compared with control (unlased).Conclusion: Nd:YAG laser application prior to photopolymerization of adhesive systems significantly increased the bond strength to dentin.

Influence of Different Surface Treatments on Bond Strength of Resin Composite Using the Intrinsic Characterization Technique

Objective: This study evaluated the influence of different surface treatments on the resin bond strength/light-cured characterizing materials (LCCMs), using the intrinsic characterization technique. The intrinsic technique is characterized by the use of LCCMs between the increments of resin composite (resin/thin film of LCCM/external layer of resin covering the LCCM).Materials and Methods: Using a silicone matrix, 240 blocks of composite (Z350/3M ESPE) were fabricated. The surfaces received different surface treatments, totaling four groups (n=60): Group C (control group), no surface treatment was used; Group PA, 37% phosphoric acid for one minute and washing the surface for two minutes; Group RD, roughening with diamond tip; and Group AO, aluminum oxide. Each group was divided into four subgroups (n=15), according to the LCCMs used: Subgroup WT, White Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup BT, Black Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup WK, White Kolor Plus pigment (Kerr) LCCM; Subgroup BK, Brown Kolor Plus pigment (Kerr) LCCM. All materials were used according to the manufacturer's instructions. After this, block composites were fabricated over the LCCMs. Specimens were sectioned and submitted to microtensile testing to evaluate the bond strength at the interface. Data were submitted to two-way analysis of variance (ANOVA) (surface treatment and LCCMs) and Tukey tests.Results: ANOVA presented a value of p<0.05. The mean values (+/- SD) for the factor surface treatment were as follows: Group C, 30.05 MPa (+/- 5.88)a; Group PA, 23.46 MPa (+/- 5.45)b; Group RD, 21.39 MPa (+/- 6.36)b; Group AO, 15.05 MPa (+/- 4.57)c. Groups followed by the same letters do not present significant statistical differences. The control group presented significantly higher bond strength values than the other groups. The group that received surface treatment with aluminum oxide presented significantly lower bond strength values than the other groups.Conclusion: Surface treatments of composite with phosphoric acid, diamond tip, and aluminum oxide significantly diminished the bond strength between composite and the LCCMs.

Bonding of Y-TZP to Dentin: Effects of Y-TZP Surface Conditioning, Resin Cement Type, and Aging

Purpose: To evaluate the effects of two surface treatments, aging, and two resin cements on shear bond strength between dentin and yttrium-stabilized tetragonal zirconia polycrystal ceramic (Y-TZP).Materials and Methods: Eighty human molars were embedded in acrylic resin and sectioned 3 mm below the occlusal plane. These teeth and 80 cylindrical Y-TZP specimens (height, 4 mm; diameter, 3.4 mm) were divided into eight groups (n=10) using the following factors: Y-TZP surface treatment (Vi: low-fusing porcelain [vitrification] + hydrofluoric acid etching + silanization or Si: tribochemical silicatization); cementation strategies (PF: Pan avia or CC: Clearfil); and storage (nonaging or aging). Bonding surfaces of 40 Y-TZP specimens received Vi treatment, and the rest received Si treatment. Half of the ceramic-tooth assemblies were cemented with Panavia, the rest with Clearfil. Shear tests were executed using 0.4-mm-thick wire at 0.5 mm/min. Data were analyzed by three-way analysis of variance and Tukey test (alpha=0.05). Fractures were analyzed.Results: Y-TZP surface treatments did not affect bond strength (p=0.762, Vi = Si), while resin cements (p<0.001, Panavia > Clearfil) and aging (p=0.006, nonaging > aging) showed a significant effect. Most failures were in adhesive at dentin-cement interfaces; no failure occurred between zirconia and cement.Conclusion: When Y-TZP ceramic is bonded to dentin, the weakest interface is that between dentin and resin cement. The resin cement/Y-TZP interface was less susceptible to failures, owing to Y-TZP surface treatments.

Direct Spectrometry: A New Alternative for Measuring the Fluorescence of Composite Resins and Dental Tissues

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

Grander system: A new technology to reduce surface tension of adhesive systems in dentistry

Background. Reduced surface tension of liquids results in higher surface wetting ability and diffusivity by the substrate. Objectives. The objective of this study was to evaluate the influence of the Grander Technology in reducing the surface tension of adhesive systems. Methods. Two adhesive systems (self-etch and total-etch) were modified by physical contact with the Grander system Flexible unit to revitalize water, for 48 h. Surface tension of adhesive systems and water in normal and grander-modified conditions was measured with a goniometer. Results. The results showed a reduction of surface tension for all conditions grander-modified between 3-15%. Conclusions. Grander Technology was effective in reducing the surface tension of the Single Bond and Clearfil SE Bond adhesive systems. Clinical significance. Grander technology was employed to restructure the molecular structure of water-based adhesive systems, which can increase their wetness capacity and therefore ensure a greater diffusibility.

Scientific collaboration network among Brazilian universities: an analysis in Dentistry area

This paper analyses the scientific collaboration network formed by the Brazilian universities that investigate in dentistry area. The constructed network is based on the published documents in the Scopus (Elsevier) database covering a period of 10 (ten) years. It is used social network analysis as the best methodological approach to visualize the capacity for collaboration, dissemination and transmission of new knowledge among universities. Cohesion and density of the collaboration network is analyzed, as well as the centrality of the universities as key-actors and the occurrence of subgroups within the network. Data were analyzed using the software UCINET and NetDraw. The number of documents published by each university was used as an indicator of its scientific production.

Pre- and post-operative evaluations of eight dogs following right nephrectomy due to Dioctophyma renale

Background: Dioctophyma renale is a large nematode distributed worldwide that may cause progressive and severe destruction of renal parenchyma.Objectives: The present study aimed to evaluate pre- and post-operatively dogs submitted to right nephrectomy due to D. renale and to assess the histopathological damage of the removed kidney.Animals and methods: Eight crossbred dogs, aged from 12 to 48 months that were unilaterally nephrectomized due to the presence of D. renale were evaluated. Physical examination, urinalysis, complete blood count, serum biochemistry, and abdominal ultrasound were performed immediately before and one month after nephrectomy. The nephrectomized right kidneys were submitted to macroscopic and microscopic evaluations.Results: Urinalysis preoperatively detected occult blood in all dogs and D. renale eggs in five cases. Complete blood count showed all parameters within the reference range, except one dog post-operatively. Serum biochemistry performed before and after surgery verified that urea, creatinine and sodium were within the reference range values in all dogs. Other findings varied among the dogs. The length and arterial resistive index mean values of the left kidney were similar pre- and post-operatively.Conclusions: Thus, the inconsiderable change in laboratory findings pre- and post-operatively was attributable to compensation by left kidney function for the removed abnormal right kidney. Right kidney histology revealed chronic nephropathy due to D. renale.Clinical importance: Imaging diagnosis should be performed on dogs suspected as carrying the disease or on those from an enzootic area since the laboratory findings are not specific except eggs in the urine.

Tumescent local anesthesia with ropivacaine in different concentrations in bitches undergoing mastectomy: plasma concentration and post-operative analgesia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Piezosurgery Applied to Implant Dentistry: Clinical and Biological Aspects

Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery.

Seven-Year Clinical Performance of Resin Composite Versus Resin-Modified Glass lonomer Restorations in Noncarious Cervical Lesions

Purpose: The purpose of this study was to comparatively assess the seven-year clinical performance of a one-bottle etch-and-rinse adhesive with resin composite (RC) and resin-modified glass ionomer (RMGI) restorations in noncarious cervical lesions.Methods and Materials: One operator placed 70 restorations (35 restorations in each group) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by two independent examiners, using modified US Public Health Service criteria at baseline and 6, 12, 24, 60, and 84 months. The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. A difference was significant if p<0.05.Results: Twenty patients were available for recall after seven years (66.6%), and 25 RC and 26 RMGI restorations out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (kappa >= 0.85). Alfa and bravo scores were classified as clinically acceptable. The McNemar test detected significant differences within RC restorations between baseline and seven-year evaluations for anatomic form, marginal integrity, and retention (p<0.05). For RMGI restorations, a significant difference was identified for marginal integrity (p<0.05). As to material comparison, the Fisher exact showed a better retention performance for RMGI restorations than for RC restorations (p<0.05). Twelve composite restorations were dislodged (52.0% retention) and three ionomer restorations were lost (88.5% retention). The cumulative success rate for RC and RMGI was 30% and 58.1%, respectively.Conclusions: After seven years of service, the clinical performance of RMGI restorations was superior to that of the adhesive system/resin composite restorations in this study.

Survival rate, load to fracture, and finite element analysis of incisors and canines restored with ceramic veneers having varied preparation design

Purpose: To evaluate the survival rate, success rate, load to fracture, and finite element analysis (FEA) of maxillary central incisors and canines restored using ceramic veneers and varying preparation designs.Methods and Materials: Thirty human maxillary central incisors and 30 canines were allocated to the following four groups (n=15) based on the preparation design and type of tooth: Gr1 = central incisor with a conservative preparation; Gr2 = central incisor with a conventional preparation with palatal chamfer; Gr3 = canine with a conservative preparation; Gr4 = canine with a conventional preparation with palatal chamfer. Ceramic veneers (lithium disilicate) were fabricated and adhesively cemented (Variolink Veneer). The specimens were subjected to 4 x 106 mechanical cycles and evaluated at every 500,000 cycles to detect failures. Specimens that survived were subjected to a load to fracture test. Bidimensional models were modeled (Rhinoceros 4.0) and evaluated (MSC.Patrans 2005r2 and MSC.Marc 2005r2) on the basis of their maximum principal stress (MPS) values. Survival rate values were analyzed using the Kaplan-Meier test (alpha = 0.05) and load to fracture values were analyzed using the Student t-test (alpha = 0.05).Results: All groups showed 100% survival rates. The Student t-test did not show any difference between the groups for load to fracture. FEA showed higher MPS values in the specimens restored using veneers with conventional preparation design with palatal chamfer.Conclusion: Preparation design did not affect the fracture load of canines and central incisors, but the veneers with conventional preparation design with palatal chamfer exhibited a tendency to generate higher MPS values.

Evaluation of tensile tetention of Y-TZP crowns after long-term aging: Effect of the core substrate and crown surface conditioning

This study evaluated the effect of the core substrate type (dentin and composite resin) on the retention of crowns made of yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP), submitted to three inner surface conditionings. For this purpose, 72 freshly extracted molars were embedded in acrylic resin, perpendicular to the long axis, and prepared for full crowns: 36 specimens had crown preparations in dentin; the remaining 36 teeth had the crowns removed, and crown preparations were reconstructed with composite resin plus fiber posts with dimensions identical to the prepared dentin. The preparations were impressed using addition silicone, and 72 Y-TZP copings for the tensile test were produced. Cementation was performed with a dual-cured cement containing phosphate monomers. For cementation, the crown preparation (dentin or resin) was conditioned with the adhesive system, and the ceramic was subjected to one of three surface treatments: isopropyl alcohol, tribochemical silica coating, or thin low-fusing glassy porcelain layer application plus silanization. After 24 hours, all specimens were submitted to thermocycling (6000 cycles) and placed in a special tensile testing device in a universal testing machine to determine failure loads. The failure modes of all samples were analyzed under a stereomicroscope. Two-way analysis of variance showed that the surface treatment and substrate type (alpha=0.05) affected the tensile retention results. The dentin substrate presented the highest tensile retention values, regardless of the surface treatment. When the substrate was resin, the tribochemical silica coating and low-fusing glaze application plus silanization groups showed the higher retention values.

Schwartz-Jampel Syndrome: a paediatric dentistry approach

Schwartz-Jampel syndrome (SJS) is a rare recessive disorder characterized mainly by myotonia. As the clinical signs and symptoms are manifested in the oromaxillofacial region, paediatric dentists may be first choice of parents that seek information and assistance to their children. A female patient diagnosed with SJS was brought to our clinic for dental treatment with main complain of difficulty on oral hygiene and mastication due to tooth crowding. The treatment included preventive measures, extraction of a supernumerary tooth and the maxillary primary second molars. Furthermore, the patient was referred to orthodontic treatment for correction of tooth crowding. When dealing with children with confirmed diagnosis of SSJ, paediatric dentists should be understand the need of planning the dental treatment considering the characteristics and possible complications associated with the syndrome in order to reduce the risks to patients, especially when surgical procedures are necessary.