Efeito da escovação sobre a rugosidade superficial, perda de massa e adesão de microrganismos na superfície de cimentos de ionômero de vidro utilizados no tratamento restaurador atraumático

Pós-graduação em Ciências Odontológicas - FOAR

Adhesive systems: important aspects related to their composition and clinical use

This literature review article addresses the types and the main components of different etch-and-rinse and self-etch adhesive systems available in the market, and relates them to their function, possible chemical interactions and influence of handling characteristics. Scanning electron microscopy (SEM) images are presented to characterize the interface between adhesives and dentin. Adhesive systems have been recently classifed according to their adhesion approaches in etch-and-rinse, self-etch and glass ionomer. The etch-and-rinse systems require a specifc acid-etch procedure and may be performed in two or three steps. Self-etch systems employ acidic monomers that demineralize and impregnate dental substrates almost at the same time. These systems are separated in one or two steps. Some advantages and defciencies were noted for etch-and-rinse and self-etch approaches, mainly for the simplifed ones due to some chemical associations and interactions. The SEM micrographs illustrate different relationships between adhesive systems and dental structures, particularly dentin. The knowledge of composition, characteristics and mechanisms of adhesion of each adhesive system is of fundamental importance to permit the adoption of ideal bonding strategies under clinical conditions.

Análise de custo-efetividade de métodos preventivos para superfície oclusal de acordo com o risco de cárie: resultados de um ensaio clínico controlado

This study presents the results of a cost-effectiveness analysis in a controlled clinical trial on the effectiveness of a modified glass ionomer resin sealant ( Vitremer, 3M ESPE) and the application of fluoride varnish (Duraphat, Colgate) on occlusal surfaces of first permanent molars in children 6-8 years of age (N = 268), according to caries risk (high versus low). Children were examined semiannually by the same calibrated dentist for 24 months after allocation in six groups: high and low risk controls (oral health education every three months); high and low risk with varnish (oral health education every three months + varnish biannually); and high and low risk with sealant (oral health education every three months + a single application of sealant). Economic analysis showed that sealing permanent first molars of high-risk schoolchildren showed a C/E ratio of US$ 119.80 per saved occlusal surface and an incremental C/E ratio of US$ 108.36 per additional saved occlusal surface. The study concluded that sealing permanent first molars of high-risk schoolchildren was the most cost-effective intervention.

Análise química, citotoxicidade e biocompatibilidade de cimentos de ionômero de vidro

Objetivo: O presente trabalho, dividido em três estudos, teve como objetivo geral identificar e quantificar a liberação de componentes e avaliar a citotoxicidade e a biocompatibilidade de cimentos de ionômero de vidro (CIVs). Método: Para o estudo 1, extratos dos CIVs Vitrebond (VB), Fuji Lining LC (FL), Vitremer (VM), Fuji II LC (FII), Ketac Fil Plus (KF) e Ketac Molar Easymix (KM) foram obtidos pela imersão de corpos-de-prova em meio de cultura celular (DMEM). Esses extratos (n=9 por grupo) foram analisados por eletrodo específico quanto à presença de flúor e por espectrometria de absorção atômica quanto à presença de alumínio e zinco. HEMA e iodobenzeno foram identificados por CG/EM (n=6). Para o estudo 2, células MDPC-23 foram colocadas em contato com os extratos dos CIVs por 24 horas. Em seguida, foram avaliadas a atividade da desidrogenase succínica (SDH) (n=8), a produção de proteína total (PT) (n=8), a atividade da fosfatase alcalina (FAL) (n=8) e a morfologia celular (n=2). Para o estudo 3, tubos de polietileno (n=24 por grupo) foram preenchidos com os CIVs e implantados no tecido subcutâneo de 42 ratos. Como grupo controle foi utilizada a guta-percha. Após 7 ou 15 dias de pós-operatório, metade dos espécimes de cada grupo e período (n=6) foi preparada para análise histológica, e os demais (n=6) para análise da expressão de genes que codificam para IL-1? e TNF-?. Resultados: Os extratos de todos os CIVs apresentaram uma concentração de flúor significativamente maior do que o meio de cultura DMEM (controle), tendo o VB liberado maior quantidade, estatisticamente significante, do que os demais CIVs. O VB foi, também, o único material que liberou quantidades relativamente altas de alumínio e de zinco. O HEMA foi identificado nos extratos de todos os CIVs modificados por resina (VB, FL, VM e FII), e o iodobenzeno... (Resumo completo, clicar acesso eletrônico abaixo)

Avaliação in vitro da adaptação cervical de coroas totais metálicas, variando os preparos dos términos cervicais, aliviando ou não as superfícies internas das coroas e empregando diferentes cimentos definitivos

Este trabalho avaliou a qualidade das adaptações cervicais de coroas totais metálicas, tendo como fonte de variação: a) o término do ombro cervical do preparo - biselado, inclinado em 1350; reto em 900, chanfro e gume de faca; b) o alívio ou não das superfícies internas das coroas; e, c) os tipos de agente de cimentação permanente, cimentos - fosfato de zinco Harvard; ionômero de vidro Ketac-Cem, policarboxilato de zinco Durelon e resinoso Panavia Ex. Inicialmente, foram confeccionados corpos-de-prova em modelos-padrão de aço inoxidável usinado, de acordo com o tipo de preparo dos términos cervicais experimentais. As cápsulas metálicas de aço inoxidável preparadas, tendo ou não alívio da superfície interna de 30 micrometros até a distância de 0,5 mm do limite do término cervical, justapunham-se precisamente e formavam um conjunto com adaptação e assentamento exatos. Estas foram cimentadas nos corpos-de-prova com os diferentes agentes cimentantes, os quais foram manipulados de acordo com as instruções dos fabricantes. Desenvolveram-se metodologias de reaproveitamento dos corpos-de-prova, estabilidade das cápsulas impedindo seu deslocamento durante a tomada das medidas e mensuração precisa. Concluiu-se que: a) as melhores médias de adaptações cervicais, semelhantes entre si, foram obtidas em modelos-padrão com ombros: lâmina de faca, ombro inclinado em 1350 e chanfro; b) as piores médias de adaptações cervicais, semelhantes entre si, foram obtidas em modelos-padrão com ombros reto em 900 e degrau em 900 com bisel de 450; c) houve melhora significativa na adaptação quando cápsulas metálicas foram cimentadas com alívio de sua superfície interna; d) os cimentos...(Resumo completo, clicar acesso eletrônico abaixo)

Resistência à tração de coroas de NiCr cimentadas sobre munhões de liga de titânio, com 4 diferentes tipos de cimentos

In this work of tensile strength was evaluated the efficacy of 4 cements (S. S. White zinc phoshate, Ketac Cem Easymix glass ionomer, RelyX Luting 2 composite resin/glass ionomer and Panavia 21 TC special acrylic resin) used to fix NiCr crowns to usinated titanium alloy abutments. Were used 40 abutments distributed in groups of 10 elements, to each material. The mechanical essays were developed at a MTS 810 universal machine, adjusted to a 0.5 mm/m velocity. The ANOVA applied to data pointed out the existence of significant differences between groups; the subsequent Tukey´s test (p<0.05) also detected significant differences, except at comparisons of phosphate versus RelyX and phosphate versus Ketac Cem. The better performance was presented by Panavia 21 (1,127.996 N); RelyX (478.197 N) showed itself similar only to phosphate (430.662 N), wich had a performance similar to that of Ketac Cem (227.705 N).

Avaliação da aplicação de ondas de ultra-som sobre cimentos de ionômero de vidro: rugosidade superficial e dureza

The application of ultrasonic waves during the initial setting of the glass ionomer cements (GIC) has demonstrated increase of the cure speed, reduction of air bubbles and improves in some mechanical properties. The aim of this study was to evaluate the effect of the ultrasound on the microhardness and the superficial roughness in two GICs (FUJI IX GP (GC Corporation) and Ketac Molar EasyMix (3M ESPE)). Forty specimens were confectioned, twenty for evaluation of the superficial roughness and twenty for evaluation of the microhardness. Half of them received for thirty seconds the ultrasonic waves application. The readings of the roughness had been carried before and after the toothbrushing test. The twenty remaining specimens had been polished with abrasive sandpapers of decreasing granulations and submitted to the hardness test. The results, analyzed for the variance analysis (ANOVA) (p<0,05), had demonstrated increase of the hardness for all the groups with the application of ultrasonic waves, being bigger for the Ketac Molar EasyMix. The ultrasound application also caused significant reduction of the superficial roughness for the Ketac Molar EasyMix. After the toothbrushing test, this last property increased for all the materials. It could be concluded that the application of ultrasonic waves was effective in increasing the superficial hardness of the materials and that it improved the roughness of the Ketac Molar EasyMix before the toothbrushing test.

Métodos preventivos em primeiro molar permanente de crianças com experiência de cárie dentária: estudo clínico comparativo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência da incorporação de nanopartículas de trimeta- fosfato de sódio associado ou não à clorexidina nas proprie- dades microbiológicas, físico-mecânicas e de redução da desmineralização de cimento de ionômero de vidro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Clinical evaluation of multiple-surface ART restorations: three-year follow-up

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

Influence of Ozone Gas and Ozonated Water Application to Dentin and Bonded Interfaces on Resin-Dentin Bond Strength

Purpose: To assess the influence of ozone gas and ozonated water application to prepared cavity and bonded interfaces on the resin/dentin bond strength of two-step etch-and-rinse adhesive systems (Adper Single Bond 2 [SB2] and XP-Bond [XP]). Materials and Methods: Sixty extracted human third molars were sectioned perpendicularly to their long axes to expose flat occlusal dentin surfaces. In experiment 1, dentin was treated with ozone before the bonding procedure, while in experiment 2, ozone was applied to resin/dentin bonded interfaces. In experiment 1, dentin surfaces were treated either with ozone gas (2100 ppm), ozonated water (3.5 ppm), or distilled water for 120 s, and then bonded with SB2 or XP according to manufacturers' instructions. Hybrid composite buildups were incrementally constructed and the teeth were sectioned into resin-dentin sticks (0.8 mm(2)). In experiment 2, dentin surfaces were first bonded with SB2 or XP, composite buildups were constructed, and bonded sticks obtained. The sticks were treated with ozone as previously described. Bonded sticks were tested under tensile stress at 1 mm/min. Silver nitrate impregnation along the resin/dentin interfaces was also evaluated under SEM. Results: Two-way ANOVA (adhesive and ozone treatment) detected no significant effect for the cross-product interaction and the main factors in the two experiments (p > 0.05), which was confirmed by the photomicrographs. Conclusion: Ozone gas and ozonated water used before the bonding procedure or on resin/dentin bonded interfaces have no deleterious effects on the bond strengths and interfaces.

Evaluación de selladores de fosas y fisuras realizados con resina y con ionómeros vítreos

En el presente trabajo se evaluaron 4 casos clínicos de pacientes con riesgo de caries pero que poseían molares sin lesiones, a los cuales se les colocó selladores de fosas y fisuras: en dos pacientes con resina y en dos pacientes con ionómero de vidrio. Los mismos fueron controlados en su permanencia en boca, los de resina en 6 meses y los de ionómero en 2 años, no encontrándose diferencias clínicas entre los materiales utilizados, debido a la diferencia en el tiempo de control de los mismos. Paralelamente, se realizó un trabajo in vitro con dos grupos de 10 molares cada uno, tratados el grupo 1 con sellador a base de resina y el grupo 2 con sellador de ionómero de vidrio. Luego de someter las muestras a la acción de un colorante (azul de metileno) se seccionaron longitudinalmente y se observaron en una lupa estereoscópica para ver si el colorante había penetrado o no por la interfase sellador/esmalte. No se encontraron diferencias estadísticamente significativas (a>0.05) entre los grupos analizados.

Direct restorative materials use in Australia in 2002

Background: This study aimed to determine the reasons for dentists' choice of materials, in particular amalgam and resin composite, in Australia. Method: A questionnaire was developed to elicit this information. The names and addresses of 1000 dentists in Australia were selected at random. The questionnaire was mailed to these dentists with an explanatory letter and reply-paid envelope. Results: A total of 560 replies were received. Regarding choice of material, 99 per cent of respondents cited clinical indication as an influencing factor, although patients' aesthetic demands (99 per cent), patients' financial situation (82 per cent), and lecturers' suggestions (72 per cent) were also reported to influence respondents' choice of materials. Twelve per cent of respondents used composite 'always', 29 per cent 'often', 32 per cent 'sometimes', 23 per cent 'seldom' and 4 per cent 'never' in extensive load-bearing cavities in molar teeth. For composite restorations in posterior teeth, 84 per cent 'always', 'often' or 'sometimes' used the total etch technique, 84 per cent used a thick glass-ionomer layer and 36 per cent never used rubber dam. Fifty-nine per cent of respondents reported a decreased use of amalgam over the previous five years. Sixty-eight per cent of respondents agreed with the statement 'discontinuation of amalgam restricts a dentist's ability to adequately treat patients'. Seventy-five per cent considered that the growth in the use of composites increased the total cost of oral health care. Conclusions: Of the respondents from Australia 73 per cent place large composite restorations in molar teeth and their choice of material is influenced greatly by clinical indications, and patients' aesthetic demands.

Probing crystallisation of a fluoro-apatite - mullite system using neutron diffraction

Real-time small angle neutron scattering and wide angle neutron scattering studies were undertaken concurrently on a glass ionomer of nominal composition 4.5(SiO2)-3(Al2O3)-1.5(P2O5)-3(CaO)-2(CaF2). Neutron studies were conducted as a function of temperature to investigate the crystallisation process. No amorphous phase separation was observed at room temperature and the onset of crystallisation was found to occur at 650°C, which is 90°C lower than previously reported. The first crystalline phase observed corresponded to fluorapatite; it was only upon further heating was the mullite phase became present. The crystallite size at 650°C was found to be ~115Å and the result was consistent across all measurements.

A study of primary teeth restored by intracoronal restorations in children participating in an undergraduate teaching programme at Cork University Dental School and Hospital, Ireland

Aim: To study the outcomes for restored primary molar teeth; to examine outcomes in relation to tooth type involved, intracoronal restoration complexity and to the material used. Materials and methods: Design: Retrospective study of primary molar teeth restored by intracoronal restorations. A series of restored primary molar teeth for children aged 6-12 years was studied. The principal outcome measure was failure of initial restoration (re-restoration or extraction). Three hundred patient records were studied to include three equal groups of primary molar teeth restored with amalgam, composite or glass ionomer, respectively. Restorative materials, the restoration type, simple (single surface) or complex (multi-surface) restoration, and tooth notation were recorded. Subsequent interventions were examined. Data were coded and entered into a Microsoft Excel database and analysis undertaken using SPSS v.18. Statistical differences were tested using the c2 test of statistical significance. Results: Of the 300 teeth studied, 61 restoration failures were recorded with 11 of those extracted. No significant differences were found between outcomes for upper first, upper second, lower first or lower second primary molars. Outcomes for simple primary teeth restored by intracoronal restorations were significantly better than those for complex intracoronal restorations (P = 0.042). Teeth originally restored with amalgam accounted for 19.7% of the 61 failures, composite for 29.5%, while teeth restored with glass ionomer represented 50.8% of all restoration failures. The differences were significant (P = 0.012). Conclusions: The majority (79.7%) of the 300 restored primary teeth studied were successful, and 3.7% teeth were extracted. Restorations involving more than one surface had almost twice the failure rate of single surface restorations. The difference was significant. Significant differences in failure rates for the three dental materials studied were recorded. Amalgam had the lowest failure rate while the failure rate with glass ionomer was the highest.