Influence of artificial aging in marginal adaptation of mixed class V cavities

The aim of this study was to investigate whether the artificial aging by thermal cycling had influenced the marginal adaptation of class V restorations with/without chlorhexidine application in the bond process. Twelve intact human third molars were used. Class V cavity preparations were performed on the buccal surface and the teeth received 35% phosphoric acid-etching procedure (Ultradent Products Inc., South Jordan, Utah, USA). Subsequently, the samples were divided in two groups: Untreated acid-etched dentin and chlorhexidine application as an adjunct in the bond process. The adhesive Single Bond 2 (3M ESPE, St. Paul, MN, USA) was used after 2% chlorhexidine application, and the restorations were performed with FiltekTM Z350 XT (3M ESPE) composite resin. The specimens were submitted to artificial aging by thermal cycling with 3,000 cycles. Analyzes were performed on scanning electron microscopy using replicas of marginal adaptation in percentage of continuous margin before and after the artificial aging. The data were analyzed by paired test and the results showed statistically significant differences in the percentage of continuous margin with/without chlorhexidine treatment before and after thermal cycling. This study concluded that the artificial aging by thermal cycling influenced the marginal adaptation of mixed class V composite restorations.

Avaliação da desadaptação marginal de estruturas metálicas obtidas com variações quanto aos tipos de cera e às técnicas de inclusão e fundição

Pós-graduação em Odontologia - FOA

Comparação da desadaptação marginal de infra-estruturas metálicas obtidas com variações na técnica de fundição, revestimentos e material para obtenção dos padrões

Pós-graduação em Odontologia - FOA

Efeito da concentração do líquido especial e da temperatura do molde de revestimentos na desadaptação marginal de coroas fundidas em titânio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Marginal adaptation of Class V restorations with current generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with FiltekTM Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Microhardness and marginal adaptation of pre-warmed composites

Objectives: The aim of this study was to examine the effect of pre-warmed composite on the microhardness and marginal adaptation. Methods: Ninety six identical class II cavities were prepared in extracted human molars and filled/cured in three 2 mm increments using a metal matrix. Two composites (Tetric Evo Ceram (IvoclarVivadent) and ELS(Saremco)) were cured with a LED curing unit (Bluephase (IvoclarVivadent)) using curing cycles of 20 and 40 seconds. The composite was used at room temperature or pre-warmed at 54.5ºC (Calset(AdDent)). Twelve teeth were filled for every composite-curing time-composite temperature combination. The teeth were thermocycled (1000 cycles at 5º and 55ºC) and then stored at 37° C for seven days . Dye penetration (basic fuchsine 5% for 8 hours) was measured using a score scale. Knoop microhardness was determined 100, 200, 500, 1000, 1500, 2500, 3500, 4500 and 5500µm from the occlusal surface at a distance of 150 and 1000µm from the metal matrix. The total degree of polymerization of a composite specimen was determined by calculating the area under the hardness curve. Results: Statistical analyses showed no difference in marginal adaptation (p>0.05). Hardness values at 150µm from the matrix were lower than those at 1000µm. There was an increase of the microhardness at the top of each increment and decrease towards the bottom of each increment. Longer curing times resulted in harder composite samples. Multiple linear regression showed that only the curing time (p<0.001) and composite material (p<0.001) had a significant association with the degree of polymerization. The degree of polymerization was not influenced by pre-warming the composite at a temperature of 54.5ºC (p=4.86). Conclusion: Polymerization time can not be reduced by pre-warming the composite on a temperature of 54.5ºC. The marginal adaptation is not compromised by pre-warming the composite.

Penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel.

PURPOSE: To evaluate the penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel. MATERIALS AND METHODS: Forty-eight maxillary and mandibular caries-free premolars scheduled for extraction for orthodontic reasons were isolated, the occlusal surfaces subjected to prophylaxis and acid-etched with orthophosphoric acid prior to the application of the VariGlass VLC glass ionomer and Concise resin sealants. The teeth were extracted, two longitudinal median sectiors from each tooth were ground to a thickness of 80-100 microns, and the sealant penetration into the fissures evaluated. The sections were placed in nitric acid to dissolve the enamel so the lengths of the tags which had penetrated into the etched enamel could be measured at different sites on the walls of the fissures. RESULTS: Both sealants adapted well to the fissures but penetrated deeper into shallow, open fissures than into deep, constricted fissures. The VariGlass VLC tags into etched enamel were generally longer than the Concise projections.

The effect of adhesive and flowable composite on postoperative sensitivity: 2-Week results

Objective: To measure 2-week postoperative sensitivity in Class II composite restorations placed with a self-etching adhesive (Clearfil SE Bond) or a total-etch adhesive (Prime&Bond NT) with or without a flowable composite as cervical increment. Method and materials: Upon approval by the University of Guarulhos Committee on Human Subjects, 100 restorations were inserted in 46 patients who required Class II restorations in their molars and premolars. Enamel and dentin walls were conditioned with a self-etching primer (for Clearfil SE Bond) or etched with 34% phosphoric acid (for Prime&Bond NT). A 1- to 2-mm-thick increment of a flowable composite (Filtek Flow) was used in the proximal box in 50% of the restorations of each adhesive. Preparations were restored with a packable composite (Surefil). The restorations were evaluated preoperatively and 2 weeks postoperatively for sensitivity to cold, air, and masticatory forces using a visual analog scale. Marginal integrity of the accessible margins was also evaluated. Statistical analysis used a mixed linear model with subject as a random effect. Results: Ninety-eight teeth from 44 subjects were observed at 2 weeks. The type of adhesive and use of flowable composite had no significant effects or interaction for any of the four outcomes of interest, ie, change from baseline to 2 weeks in sensitivity and response time for the cold or air stimulus. For the air stimulus, the overall average change from baseline was not significant for either sensitivity or response time. For the cold stimulus, the overall average change from baseline was significant for both sensitivity and response time. No case of sensitivity to masticatory forces was observed. Conclusion: No differences in postoperative sensitivity were observed between a self-etch adhesive and a total-etch adhesive at 2 weeks. The use of flowable composite did not decrease postoperative sensitivity.

Influence of resin composite insertion technique in preparations with a high C-factor

Objective: To evaluate the marginal microleakage in enamel and dentin/cementum walls in preparations with a high C-factor, using 3 resin composite insertion techniques. The null hypothesis was that there is no difference among the 3 resin composite insertion techniques. Method and Materials: Standardized Class 5 cavities were prepared in the lingual and buccal aspects of 30 caries-free, extracted third molars. The prepared teeth were randomly assigned to 3 groups: (1) oblique incremental placement technique, (2) horizontal incremental placement technique, and (3) bulk insertion (single increment). The preparations were restored with a 1-bottle adhesive (Single Bond, 3M ESPE) and microhybrid resin composite (Z100, 3M ESPE). Specimens were isolated with nail varnish except for a 2-mm-wide rim around the restoration and thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50 wt% silver nitrate for 24 hours, followed by 8 hours in a photo-developing solution and evaluated for microleakage using an ordinal scale of 0 to 4. The microleakage scores obtained from occlusal and gingival walls were analyzed with Wilcoxon and Kruskal-Wallis nonparametric tests. Results: The null hypothesis was accepted. The horizontal incremental placement technique, the oblique incremental technique, and bulk insertion resulted in statistically similar enamel and dentin microleakage scores. Conclusion: Neither the incremental techniques nor the bulk placement technique were capable of eliminating the marginal microleakage in preparations with a high C-factor.

Influence of surface sealants on microleakage of composite resin restorations

Purpose: The purpose of this study was to verify the influence of surface sealants and dentin adhesive systems on the microleakage of composite restorations. Methods: Class V cavities were made on the buccal faces of 100 permanent third molars and restored with Z250. After 24 hours, they were submitted to polishing and finishing processes. The teeth were divided into groups according to the sealant agent: group 1 - Single Bond; group 2 - Opti Bond Solo Plus; group 3 - Fortify; group 4 - Fortify Plus; and group 5 - control without sealant. The analysis of immediate microleakage was performed in 10 restorations from each group, soon after the sealing. The other 10 specimens from each group were submitted to tooth-brushing and thermal cycles. The teeth were isolated and immersed in 2% methylene blue solution, washed in tap water, and sectioned in the buccolingual direction. The percentage of marginal leakage was calculated using an image analysis program, and results were submitted to analysis of variance and Tukey's test. Results: All the sealed groups demonstrated lower microleakage values compared to the control group. Group 3, sealed with Fortify, presented the lowest mean microleakage values. Conclusion: The application of surface sealants effectively decreased the microleakage in composite resin restorations.

In vitro-evaluation of secondary caries formation around restoration.

The objective of this in vitro study was to evaluate demineralization around restorations. Class V preparations were made on the buccal and lingual surfaces of each tooth. TPH (Group 1), Fuji II LC (Group 2), Tetric (Group 3), Dyract (Group 4), GS 80 (Group 5) and Chelon Fil (Group 6) were randomly placed in equal numbers of teeth. The teeth were submitted to a pH-cycling model associated with a thermocycling model. Sections were made and the specimens were examined for the presence of demineralization under polarized light microscopy. Demineralization was significantly reduced with Chelon Fil (Group 6). Furthermore, a similar inhibitory effect on the development of demineralization was observed in Groups 2, 4 and 5.

Comparação da adaptação cervical de estruturas metálicas para metalo-cerâmica obtidas através de técnica de fundição rápida e convencional, utilizando três revestimentos comerciais

Pós-graduação em Odontologia - FOA

Inlays Made From a Hybrid Material: Adaptation and Bond Strengths

The aim of this study was to evaluate the internal fit, marginal adaptation, and bond strengths of inlays made of computer-aided design/computer-aided manufacturing feldspathic ceramic and polymer-infiltrated ceramic. Twenty molars were randomly selected and prepared to receive inlays that were milled from both materials. Before cementation, internal fit was achieved using the replica technique by molding the internal surface with addition silicone and measuring the cement thicknesses of the pulpal and axial walls. Marginal adaptation was measured on the occlusal and proximal margins of the replica. The inlays were then cemented using resin cement (Panavia F2.0) and subjected to two million thermomechanical cycles in water (200 N load and 3.8-Hz frequency). The restored teeth were then cut into beams, using a lathe, for microtensile testing. The contact angles, marginal integrity, and surface patterns after etching were also observed. Statistical analysis was performed using two-way repeated measures analysis of variance (p<0.05), the Tukey test for internal fit and marginal adaptation, and the Student t-test for bond strength. The failure types (adhesive or cohesive) were classified on each fractured beam. The results showed that the misfit of the pulpal walls (p=0.0002) and the marginal adaptation (p=0.0001) of the feldspathic ceramic were significantly higher when compared to those of the polymer-infiltrated ceramic, while the bond strength values of the former were higher when compared to those of the latter. The contact angle of the polymer-infiltrated ceramic was also higher. In the present study, the hybrid ceramic presented improved internal and marginal adaptation, but the bond strengths were higher for the feldspathic ceramic.

Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial

The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time.

Avaliação da adaptação marginal de diferentes tipos de restaurações obtidas por CAD/CAM e métodos convencionais

The past few decades have brought many changes to the dental practice and the technology has become ready available. The result of a satisfactory rehabilitation treatment basically depends on the balance between biological and mechanical factors. The marginal adaptation of crowns and prosthetic structures is vital factor for long-term success. The development of CAD / CAM technology in the manufacture of dental prostheses revolutionized dentistry, this technology is capable of generating a virtual model from the direct digital scanning from the mouth, casts or impressions. It allows the planning and design of the structure in a computered software. The virtual projects are obtained with high precision and a significant reduction in clinical and laboratory time. Thus, the present study (Chapters 1, 2 and 3) computed microtomography was used to evaluate, different materials, different CAD/CAM systems, different ways of obtaining virtual model (with direct or indirect scanning), and in addition, also aims to evaluate the influence of cementing agent in the final adaptation of crowns and copings obtained by CAD / CAM. Furthermore, this study (Chapter 4, 5 and 6) also aims to evaluate significant differences in vertical and horizontal misfits in abutment-free frameworks on external hexagon implants (HE) using full castable UCLAs, castable UCLAs with cobalt-chromium pre-machined bases and obtained by CAD / CAM with CoCr or Zirconia by different scanning and milling systems. For this, the scanning electron microscopy and interferometry were used. It was concluded that the CAD / CAM technology is capable to produce restorations, copings and screw-retained implant-supported frameworks in different materials and systems offering satisfactory results of marginal accuracy, with significative reduction in clinical and laboratory time.