Avaliação da eficiência de adesão de um cimento resinoso autocondicionante (self-adhesive) sobre esmalte e dentina: efeito termociclagem e condicionamento dental : estudo in vitro

Pós-graduação em Odontologia Restauradora - ICT

Direct Adhesive Pin-Retained Restorations for Severely Worn Dentition Treatment: A 1.5-Year Follow-Up Report

A superfície oclusal excessivamente desgastada pode resultar em desarmonia oclusal e prejuízo à estética e função. Como abordagem terapêutica, coroas unitárias convencionais têm sido propostas, porém este tipo de tratamento é complexo, altamente invasivo e caro. Este relato de caso descreve os resultados clínicos de um tratamento alternativo minimamente invasivo baseado em restaurações adesivas diretas retidas por pinos. Uma paciente de 64 anos apresentando dentição severamente desgastada, problemas mastigatórios relacionados às ausências dentárias e hipersensibilidade dental generalizada foi encaminhada para tratamento. O adequado plano de tratamento baseado no enceramento diagnóstico foi utilizado para guiar a reconstrução dos dentes anteriores superiores com resina composta direta sobre pinos dentinários auto-rosqueáveis. Como os dentes inferiores remanescentes eram extremamente desgastados, uma sobre-dentadura dento-suportada foi instalada. Uma placa estabilizadora também foi utilizada de modo a proteger as restaurações. Este tratamento constitui uma alternativa mais acessível de reabilitação de boca total com resultados estéticos e funcionais positivos após 1,5 anos de acompanhamento.

Exposed Collagen In Resin Bonds to Caries-affected Dentin After Dentin Treatment with Aqueous and Alcoholic Chlorhexidine Solutions

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efficacy of Surface Treatments on the Bond Strength of Resin Cements to Two Brands of Zirconia Ceramic

Purpose: To compare the shear bond strength (SBS) of two cements to two Y-TZP ceramics subjected to different surface treatments.Materials and Methods: Zirconia specimens were made from Lava (n = 36) and IPS e.max ZirCAD (n = 36), and their surfaces were treated as follows: no treatment (control), silica coating with 30-mu m silica-modified alumina (Al2O3) particles (CoJet Sand), or coating with liners Lava Ceram for Lava and Intensive ZirLiner for IPS e.max ZirCAD. Composite resin cylinders were bonded to zirconia with Panavia F or RelyX Unicem resin cements. All specimens were thermocycled (6000 cycles at 5 degrees C/55 degrees C) and subjected to SBS testing. Data were analyzed by post-hoc test Tamhane T2 and Scheffe tests (alpha = 0.05). Failure mode was analyzed by stereomicroscope and SEM.Results: With both zirconia brands, CoJet Sand showed significantly higher SBS values than control groups only when used with RelyX Unicem (p = 0.0001). Surface treatment with liners gave higher SBS than control groups with both ceramic brands and cements (p < 0.001). With both zirconia brands, the highest SBS values were obtained with the CoJet and RelyX Unicem combination (> 13.47 MPa). Panavia F cement showed significantly better results when coupled with liner surface treatment rather than with CoJet (p = 0.0001, SBS > 12.23 MPa). In untreated controls, Panavia F showed higher bond strength than RelyX Unicem; the difference was significant (p = 0.016) in IPS e.max ZirCAD. The nontreated specimens and those treated with CoJet Sand exhibited a high percentage of adhesive and mixed A (primarily adhesive) failures, while the specimens treated with liners presented an increase in mixed A and mixed C (primarily cohesive) failures as well as some cohesive failure in the bulk of Lava Ceram for both cements.Conclusion: CoJet Sand and liner application effectively improved the SBS between zirconia and luting cements. This study suggests that different interactions between surface treatments and luting cements yield different SBS: in clinical practice, these interactions should be considered when combining luting cements with surface treatments in order to obtain the maximum bond strength to zirconia restorations.

Influence of Adhesive Restorations on Diffusion of H2O2 Released from a Bleaching Agent and Its Toxic Effects on Pulp Cells

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

Bond Strength of Different Resin Cement and Ceramic Shades Bonded to Dentin

Purpose: To evaluate the microtensile bond strength (MTBS) of ceramic cemented to dentin varying the resin cement and ceramic shades.Materials and Methods: Two VITA VM7 ceramic shades (Base Dentine 0M1 and Base Dentine 5M3) were used. A spectrophotometer was used to determine the percentage translucency of ceramic (thickness: 2.5 mm). For the MTBS test, 80 molar dentin surfaces were etched and an adhesive was applied. Forty blocks (7.2 x 7.2 x 2.5 mm) of each ceramic shade were produced and the ceramic surface was etched (10% hydrofluoric acid) for 60 s, followed by the application of silane and resin cement (A3 yellow and transparent). The blocks were cemented to dentin using either A3 or transparent cement. Specimens were photoactivated for 20 s or 40 s, stored in distilled water (37 degrees C/24 h), and sectioned. Eight experimental groups were obtained (n = 10). Specimens were tested for MTSB using a universal testing machine. Data were statistically analyzed using ANOVA and Tukey's post-hoc tests (alpha <= 0.05).Results: The percentage translucency of 0M1 and 5M3 ceramics were 10.06 (+/- 0.25)% and 1.34 (+/- 0.02)%, respectively. The lowest MTBS was observed for the ceramic shade 5M3. For the 0M1 ceramic, the A3 yellow cement that was photocured for 20 s exhibited the lowest MTBS, while the transparent cement that was photocured for 40 s presented the highest MTBS.Conclusions: For the 2.5-mm-thick 5M3 ceramic restorations, the MTBS of ceramic cemented to dentin significantly increased. The dual-curing cement Variolink II photocured for 40 s is not recommended for cementing the Base Dentine 5M3 feldspathic ceramic to dentin.

Can Heat Treatment Procedures of Pre-hydrolyzed Silane Replace Hydrofluoric Acid in the Adhesion of Resin Cement to Feldspathic Ceramic?

Purpose: To evaluate the influence of heat treatment (HT) procedures of a pre-hydrolyzed silane on bond strength of resin cement to a feldspathic ceramic.Materials and Methods: Ceramic and composite blocks (N = 30) were divided into six groups (n = 5) and subjected to the following conditioning procedures: G1: 9.6% hydrofluoric acid (HF) for 20 s + silane (RelyX Ceramic Primer, 3M ESPE) + resin cement (Panavia F2.0, Kuraray) (control); G2: HF (20 s) + silane + heat treatment in furnace (HTF) (100 degrees C, 2 min) + resin cement; G3: silane + HTF + resin cement; G4-HF (20 s) + silane + heat treatment with hot air (HTA) (50 +/- 5 degrees C for 1 min) + resin cement; G5: silane + HTA + resin cement; G6: silane + resin cement. The microtensile bond strength (MTBS) test was performed using a universal testing machine (1 mm/min). After debonding, the substrate and adherent surfaces were analyzed using a stereomicroscope and SEM to categorize the failure types. The data were statistically evaluated using one-way ANOVA and Tukey's test (5%).Results: The control group (G1) showed no pre-test failures and presented significantly higher mean MTBS (16.01 +/- 1.12 MPa) than did other groups (2.63 +/- 1.05 to 12.55 +/- 1.52 MPa) (p = 0.0001). In the groups where HF was not used, HTF (G3: 12.55 +/- 1.52 MPa) showed significantly higher MTBS than did HTA (G5: 2.63 +/- 1.05 MPa) (p < 0.05). All failure types were mixed, ie, adhesive between the resin cement and ceramic accompanied by cohesive failure in the cement.Conclusion: Heat treatment procedures for the pre-hydrolyzed silane either in a furnace or with the application of hot air cannot replace the use of HF gel for the adhesion of resin cement to feldspathic ceramic. Yet when mean bond strengths and incidence of pre-test failures are considered, furnace heat treatment delivered the second best results after the control group, being considerably better than hot air application.

Effect of Post-silanization Heat Treatments of Silanized Feldspathic Ceramic on Adhesion to Resin Cement

Purpose: To evaluate the effect of post-silanization heat treatment of a silane agent and rinsing with hot water of silanized CAD/CAM feldspathic ceramic surfaces on the microtensile bond strength between resin cement and the ceramic, before and after mechanical cycling.Materials and Methods: Blocks measuring 10 x 5.7 x 3.25 mm(3) were produced from feldspathic ceramic cubes (VITA Mark II, VITA Zanhfabrik). Each ceramic block was duplicated in composite resin using a template made of polyvinylsiloxane impression material. Afterwards, ceramic and corresponding resin composite blocks were ultrasonically cleaned and randomly divided according to the 5 strategies used for conditioning the ceramic surface (n = 10): GHF: etching with hydrofluoric acid 10% + rinsing with water at room temperature + silanization at 20 degrees C; G20: silanization; G77: silanization + oven drying at 77 degrees C; G20r: silanization + hot water rinsing; G77r: silanization + oven drying at 77 C + hot water rinsing. The resin and ceramic blocks were cemented using a dual-curing resin cement. Every group was divided in two subgroups: aging condition (mechanical cycling, designated as a) or non-aging (designated as n). All the bonded assemblies were sectioned into microsticks for microtensile bond strength (mu TBS) testing. The failure mode of the tested specimens was assessed and mu TBS data were statistically analyzed in two ways: first 2-way ANOVA (GHF, G20 and G77 in non-aging/aging conditions) and 3-way ANOVA (temperature x rinsing x aging factors, excluding GHF), followed by Tukey's test (p = 0.05).Results: The 2-way ANOVA revealed that the mu TBS was significantly affected by the surface treatment (p < 0.001) but not by aging (p = 0.68), and Tukey's test showed that G77-n/G77-a (18.0 MPa) > GHF-n/GHF-a (12.2 MPa) > G20-n/G20-a (9.1 MPa). The 3-way ANOVA revealed that the mu TBS was significantly affected by the heat treatment and rinsing factors (p < 0.001), but not affected by aging (p = 0.36). The rinsing procedure decreased, while oven drying increased the bond strengths. Group G77, in both non-aging and aging conditions (18.6-17.4 MPa), had the highest bond values. Failure modes were mainly mixed for all groups.Conclusion: Oven drying at 77 degrees C improved the bond strength between the resin cement and feldspathic ceramic, but hot water rinsing reduced the bond strength and should not be recommended.

Effect of Resin Cement Type on the Microtensile Bond Strength to Lithium Disilicate Ceramic and Dentin Using Different Test Assemblies

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Silica-based Nano-coating on Zirconia Surfaces Using Reactive Magnetron Sputtering: Effect on Chemical Adhesion of Resin Cements

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

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.

Bonding of facial silicon with nanoparticles to an acrylic resin substrate

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

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.

Effect of time between adhesive application and photoactivation on adhesion and collagen exposure

Fundacao de Amparo a Pesquisa do Estado de sao Paulo (FAPESP)

Responses of dental pulp cells to a less invasive bleaching technique applied to adhesive restored teeth

To assess the cytotoxicity of 35% hydrogen peroxide (HP) bleaching gel applied for 15 min to sound or restored teeth with two-step self-etching adhesive systems and composite resin. Materials and Methods: Sound and restored enamel/dentin disks were stored in water for 24 h or 6 months + thermocycling. The disks were adapted to artificial pulp chambers and placed in compartments containing culture medium. Immediately after bleaching, the culture medium in contact with dentin was applied for 1 h to previously cultured odontoblast-like MDPC-23 cells. Thereafter, cell viability (MTT assay) and morphology (SEM) were assessed. Data were analyzed by two-way ANOVA and Tukey's test (a = 5%). Results: In comparison to the negative control group (no treatment), no significant cell viability reduction occurred in those groups in which sound teeth were bleached. However, a significant decrease in cell viability was observed in the adhesive-restored bleached groups compared to negative control. No significant difference among bleached groups was observed with respect to the presence of restoration and storage time. Conclusion: The application of 35% HP bleaching gel to sound teeth for 15 min does not cause toxic effects in pulp cells. When this bleaching protocol was performed in adhesive-restored teeth, a significant toxic effect occurred.