Light-curing Time and Aging Effects on the Nanomechanical Properties of Methacrylate- and Silorane-based Restorations

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

Clinical Trial Evaluating Color Change and Tooth Sensitivity Throughout and Following In-office Bleaching

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

Evaluation of the Radiopacity of Esthetic Root Canal Posts

The radiopacity of esthetic root canal posts may impair the assessment of their fit to the root canal when using radiographic images. This study determined in vitro the radiographic density of esthetic root canal posts using digital images. Thirty-six roots of human maxillary canines were assigned to six groups (N = 6 per group): Reforpost (RP); Aestheti-Plus (AP); Reforpost MIX (RPM); D.T. Light Post (LP); Reforpost Radiopaque (RPR); and White Post DC (WP). Standardized digital images of the posts were obtained in different conditions: outside the root canal, inside the canal before and after cementation using luting material, and with a tissue simulator. Analysis of variance was used to compare the radiopacity mean values among the posts outside the root canal and among the posts under the other conditions, and the t unpaired test to compare the radiopacity between the posts and the dentin, and between the posts and the root canal space. There was no statistically significant difference in radiopacity between RP and RPM, and LP and WP. AP posts showed radiopacity values significantly lower than those for dentin. No statistically significant difference was found between posts (RP and AP) and the root canal space. A statistically significant difference was observed between the luted and non-luted posts; additionally, luted posts with and without tissue simulator showed no significant differences. Most of the cement-luted posts analyzed in this study were distinguishable from the density of adjacent dentin surfaces, allowing radiographic confirmation of the fit of the post in the canal.Clinical SignificanceThe success of using esthetic root canal posts depends mainly on the fit of the post within the canal.[1] The radiopacity of a post allows for radiographic imaging to be used to determine the fit, an important factor in a clinical perspective.

Evaluation of bond strength and thickness of adhesive layer according to the techniques of applying adhesives in composite resin restorations

Adhesive restorations have increasingly been used in dentistry, and the adhesive system application technique may determine the success of the restorative procedure. The aim of this study was to evaluate the influence of the application technique of two adhesive systems (Clearfil SE Bond and Adper Scotchbond MultiPurpose) on the bond strength and adhesive layer of composite resin restorations. Eight human third molars were selected and prepared with Class I occlusal cavities. The teeth were restored with composite using various application techniques for both adhesives, according to the following groups (n = 10): group 1 (control), systems were applied and adhesive was immediately light activated for 20 seconds without removing excesses; group 2, excess adhesive was removed with a gentle jet of air for 5 seconds; group 3, excess was removed with a dry microbrush-type device; and group 4, a gentle jet of air was applied after the microbrush and then light activation was performed. After this, the teeth were submitted to microtensile testing. For the two systems tested, no statistical differences were observed between groups 1 and 2. Groups 3 and 4 presented higher bond strength values compared with the other studied groups, allowing the conclusion that excess adhesive removal with a dry micro-brush could improve bond strength in composite restorations. Predominance of adhesive fracture and thicker adhesive layer were observed via scanning electron microscopy (SEM) in groups 1 and 2. For groups 3 and 4, a mixed failure pattern and thinner adhesive layer were verified. Clinicians should be aware that excess adhesive may negatively affect bond strength, whereas a thin, uniform adhesive layer appears to be favorable. (Quintessence Int 2013;44:9-15)

Marginal adaptation of class II cavities restored with bulk-fill composites

Objectives: To determine the marginal adaptation of bulk-fill composites in class II MO cavities.Methods: Standardized class II MO cavities with bevelled enamel margins were prepared in 40 extracted human molars. The teeth were randomly assigned to one of the five experimental groups (n = 8). The teeth were restored with two horizontal increments of composite (4 mm and 2 mm thickness). The experimental groups were (1st/2nd increment): Gr. A - Venus Bulk-Fill/Venus Diamond; Gr. B - Tetric EvoCeram BulkFill/Tetric EvoCeram; Gr. C - Surefil SDR/Ceram-X; Gr. D - SonicFill; Gr. E - Ceram-X/Ceram-X (control). After finishing procedures, impressions were made using a polyvinyl siloxane and epoxy resin replicas were obtained. Thermo-mechanical stressing was carried out 24 h after the restorative procedure. All specimens were submitted to 240,000 occlusal loading and simultaneous 600 thermal cycles in water at 5 degrees C and 50 degrees C. After loading, a new set of epoxy resin replicas was obtained. Scanning electron microscopy was carried out at 200x magnification. Results for the marginal adaptation were expressed as percentages of continuity relative to the exposed interface and analyzed by ANOVA and Duncan post hoc test (p < 0.05).Results: In enamel, no significant differences were detected before and after thermo-mechanical loading between groups. In dentine, the worst results were observed in Gr. A.Conclusion: By applying simple layering techniques, bulk-fill materials do not allow better marginal adaptation than a standard composite. Clinical significance: A new class of resin-base composite (bulk-fill) was recently launched on the market. The bulk-fill composites exhibited adequate marginal adaptation and similar to the results of the standard composite. (C) 2014 Elsevier Ltd. All rights reserved.

The effect of an Er,Cr:YSGG laser on external adaptation of healthy and decayed cavities

The aim of this study was to evaluate the influence of chlorhexidine and Er, Cr:YSGG laser irradiation on the bond strength and external adaptation in mixed healthy and caries-affected class V cavities before and after thermal cycling. Thirty-six cavity preparations were made in mixed class V buccal human molars, half of them being artificially caries-induced. Any remaining affected dentin was removed from the cavity with a round burr at low speed. The teeth were divided into six groups, according to cleaning agent for both healthy and caries-induced dentin: no treatment, chlorhexidine and erbium, chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation. A Filtek P90 (3M ESPE, St Paul, MN, USA) silorane adhesive restorative system was used. The specimens were subjected to 5000 thermal cycles (5-55 degrees C 60 min). Epoxy replicas were obtained to characterize the external adaptation under scanning electron microscopy. The average percentages of non-continuous margins were 5.41% and 6.49% in enamel dentin before thermal cycling and 25% and 33.7% after thermal cycling, respectively. The caries-affected and laser irradiated cavities showed higher non-continuous margins. Thermal cycling was able to raise the percentage of non-continuous margin for all groups. Chlorhexidine did not affect the marginal adaptation results, and the Er,Cr:YSGG laser irradiation showed significantly worse results compared with the control group.

A split-mouth randomized clinical trial of conventional and heavy flowable composites in class II restorations

Objective: The aim of this study was to evaluate the 2-year clinical performance of class II restorations made with a composite resin with two different viscosities.Methods: 47 patients received two class II restorations (n = 94), one made with GrandioSO (conventional viscosity CV), and the other with GrandioSO Heavy Flow (flowable viscosity FV), subjecting both materials to the same clinical conditions. The self-etching adhesive Futurabond M was used for all restorations. The composites were inserted using the incremental technique. The restorations were evaluated using the modified USPHS criteria according to the periods: baseline, 6 months, 1 year and 2 years after restorative procedures.Results: After 24 months, 40 patients attended the recall and 78 restorations were evaluated. In all periods, no secondary caries was observed. After 6 months, there were slightly overall changes of scores for most parameters. After 24 months, the higher number of changes from score Alfa to Bravo was observed for marginal discolouration (32.5% CV and 39.5% FV) and colour match (15% CV and 31.6% FV), followed by proximal contact (25% CV and 23.7% FV) and marginal adaptation (20% CV and 21.1% FV). For wear, surface texture and postoperative sensitivity the changes were very small. Just two restorations were lost during the 24-month follow up. Less than 5% of all restorations showed postoperative sensitivity. Chi-square test showed no significant differences between the two materials for all parameters analysed.Conclusion: After 2 years of clinical service, no significant differences were observed between GrandioSO conventional and GrandioSO Heavy Flow for the parameters analysed. Both materials provided acceptable clinical behaviour in class II restorations. Clinical Significance: This study presents the possibility of using a flowable composite with high filler content, for performing class II restorations. (C) 2014 Elsevier Ltd. All rights reserved.

Dentin Bond Strength: Influence of Er:YAG and Nd:YAG Lasers

The aim of this study was to investigate the effects of Er:YAG and Nd:YAG lasers on the shear bond strength of composite resin to dentin. The coronal portion of 56 human molars was divided into three parts, and the dentin thickness was standardized at 2 mm. A 3-mm hole was marked in the center of each tooth with sealing tape paper. The specimens (n = 14) were then divided into four groups: (1) acid etching + Single Bond (SB) (control), (2) acid etching + SB + Nd: YAG laser irradiation (before adhesive curing), (3) thermal etching with the Er: YAG laser + SB, and (4) thermal etching with the Er: YAG laser + SB + Nd: YAG laser irradiation (before adhesive curing). A composite resin cylinder was built into the delimited area for conducting the shear bond strength test on the universal testing machine. The means +/- standard deviations were: group 1, 17.05 +/- 4.15 MPa; group 2, 16.90 +/- 3.36 MPa; group 3, 12.12 +/- 3.85 MPa; and group 4, 12.92 +/- 2.73 MPa. Groups 1 and 2 presented significantly higher values than groups 3 and 4. It was concluded that conventional etching with 37% phosphoric acid yielded significantly higher bond strength values compared to thermal etching with the Er:YAG laser. The Nd:YAG laser did not significantly influence the bond strength.

Avaliação da rugosidade superficial de restaurações estéticas e do esmalte adjacente após o uso de diferentes instrumentos rotatórios de acabamento e polimento

Pós-graduação em Odontologia - ICT

Avaliação in vitro da resistência adesiva ao cisalhamento entre a dentina bovina, cimentos resinosos e materiais restauradores indiretos, tratados ou não com jato de óxido de alumínio, ácido fluorídrico e silano

The purpose of this study was to evaluate in vitro the shear bond strenght to bovine dentin, during 24h and 30 days with the following variables: resin cements Enforce and Panavia F; aesthetics restorative materials Art Glass, IPS Empress 2 and Targis, with surface treatment with microetching with aluminium oxide, fluoridric acid and silane. Two hundred eighty eight sound bovine teeth from 3 years old animals constituted the samples after inclusion on polyester resin box. lnstron model 430 Universal Testing Machine, a crosshead speed 0,5 mm/min and load cells of 500 Kg, was used for shear bond strenght testing (MPa). The results were statistically analysed by ANOVA The best result was obtained with /PS Empress 2, microetched with aluminium oxide, fluoridric acid and silane, cemented with Panavia F and stored in distilled water, 3f'C during 30 days

Desempenho adesivo de sistemas de união à dentina aplicados in vivo e in vitro: efeito da pressão intrapulpar e profundidade dentinária

O objetivo do presente estudo foi investigar a influência da pressão intrapulpar e da profundidade dentinária sobre o desempenho adesivo de dois agentes de união à dentina, Single Bond (3M ESPE, St. Paul, MN, EUA) e Clearfil SE Bond (Kuraray, Tokyo, Japão), aplicados in vitro e in vivo. Quarenta e oito prémolares superiores hígidos foram selecionados e os pares pertencentes aos mesmos pacientes foram aleatoriamente distribuídos em 4 grupos experimentais de acordo com o sistema adesivo e a pressão intrapulpar, presente ou ausente. Dos dentes pertencentes ao mesmo par, um foi tratado in vivo e o outro in vitro. A ausência ou presença de pressão intra-pulpar foi determinada in vivo pelo uso de anestésicos locais com ou sem vasoconstritor, respectivamente. In vitro, os dentes foram mantidos sob pressão hidrostática de 15 cm de água por 24 horas. Cavidades de classe I foram preparadas e os sistemas adesivos aplicados de acordo com a recomendação dos fabricantes, seguidos da restauração incremental em resina composta. Para os dentes tratados in vitro, os mesmos procedimentos restauradores foram realizados após 6 meses de armazenagem em solução contendo timol 0,1%. Espécimes com área de secção transversal de 1 mm2 foram obtidos e submetidos ao ensaio mecânico de microtração. In vivo, ambos os sistemas adesivos apresentaram desempenho adesivo comparável, enquanto in vitro, o sistema Single Bond foi superior ao sistema Clearfil SE Bond. Esse último não foi influenciado por nenhuma das variáveis estabelecidas no estudo, ou seja, aplicação in vitro ou in vitro, presença de pressão intrapulpar e profundidade em dentina. O sistema Single Bond aplicado sob pressão intrapulpar positiva sofreu variação significante de resistência de união em função da profundidade da dentina, ou seja, em dentina profunda seu desempenho adesivo... (Resumo completo, clicar acesso eletrônico abaixo)

Risco de desordens músculo-esqueléticas nos membros superiores de graduandos de Odontologia

Este estudo teve por objetivo avaliar o risco de desenvolvimento de desordens músculo-esqueléticas nos membros superiores de graduandos de Odontologia considerando as variáveis sexo, tipo de procedimento clínico executado, região da boca tratada e prática do trabalho a quatro mãos. Foram avaliados alunos, de ambos os sexos, matriculados no oitavo semestre do curso de graduação da Faculdade de Odontologia de Araraquara - UNESP. Foram efetuadas tomadas fotográficas durante a realização de 283 procedimentos clínicos, utilizando-se máquina fotogrática digital. Para análise das fotografias, utilizou-se o programa Image Tool. As posturas de trabalho adotadas por cada estudante na sua atuação como “operador” foram observadas pelo método RULA (Rapid Upper Limb Assessment), o qual inclui o uso de um diagrama de análise de postura do indivíduo e três tabelas de escores que permitem a avaliação da exposição aos fatores de risco para o desenvolvimento de desordens músculo-esqueléticas. As fotografias foram analisadas por um professor da área de ergonomia calibrado (_=0,91). Para cada procedimento foi atribuído um escore de risco final. Os procedimentos executados foram classificados em duas grandes categorias: procedimentos preparatórios e procedimentos restauradores/reabilitadores. Os dados de risco de desordens músculoesqueléticas nos membros superiores foram apurados, e sua prevalência foi estimada por ponto e por intervalo de confiança de 95%. O estudo da associação do risco de desordens músculo-esqueléticas às variáveis de interesse foi realizado por meio do Teste de Qui-quadrado (_ 2). O nível de significância adotado foi de 5%. Observou-se que na maioria dos procedimentos executados o risco de desordens músculo-esqueléticas segundo a classificação... (Resumo completo, clicar acesso eletrônico abaixo)

Aspectos relacionados a procedimentos restauradores em odontopediatria

O objetivo deste texto foi realizar uma revisão crítica de trabalhos realizados após o doutoramento do autor, de parte de uma linha de pesquisa focalizada na dentística em odontopediatria. Desta forma, foram revisados artigos referentes a alguns procedimentos realizados na prática da odontologia restauradora, envolvendo estudos de microinfiltração, onde foi avaliada a influência de técnicas e materiais restauradores sobre este fenômeno. Outros trabalhos revisados relacionaram-se ao uso do microscópio eletrônico de varredura. Neste caso, foram descritos estudos que avaliaram aspectos micromorfológicos das estruturas dentárias (esmalte e dentina) de dentes permanentes, mas principalmente decíduos. Foram observados os efeitos de diferentes tratamentos realizados sobre as estruturas dentárias, como a ação de agentes condicionadores e métodos de desgaste das estruturas dentárias (laser, abrasão a ar, instrumentos cortantes rotatórios e ponta CVD). Também foram apresentados os trabalhos que avaliaram a interface adesiva, após diferentes tratamentos da dentina. Finalmente foram realizados comentários sobre os trabalhos revisados e apresentadas as tendências futuras desta linha de pesquisa.

Methods to evaluate and strategies to improve the biocompatibility of dental materials and operative techniques

Objective. The general aim of this article is to describe the state-of-the-art of biocompatibility testing for dental materials, and present new strategies for improving operative dentistry techniques and the biocompatibility of dental materials as they relate to their interaction with the dentin-pulp complex.Methods. The literature was reviewed focusing on articles related to biocompatibilty testing, the dentin-pulp complex and new strategies and materials for operative dentistry. For this purpose, the PubMed database as well as 118 articles published in English from 1939 to 2014 were searched. Data concerning types of biological tests and standardization of in vitro and in vivo protocols employed to evaluate the cytotoxicity and biocompatibility of dental materials were also searched from the US Food and Drug Administration (FDA), International Standards Organization (ISO) and American National Standards Institute (ANSI).Results. While there is an ongoing search for feasible strategies in the molecular approach to direct the repair or regeneration of structures that form the oral tissues, it is necessary for professionals to master the clinical therapies available at present. In turn, these techniques must be applied based on knowledge of the morphological and physiological characteristics of the tissues involved, as well as the physical, mechanical and biologic properties of the biomaterials recommended for each specific situation. Thus, particularly within modern esthetic restorative dentistry, the use of minimally invasive operative techniques associated with the use of dental materials with excellent properties and scientifically proved by means of clinical and laboratory studies must be a routine for dentists. This professional and responsible attitude will certainly result in greater possibility of achieving clinical success, benefiting patients and dentists themselves.Signcance. This article provides a general and critical view of the relations that permeate the interaction between dental materials and the dentin-pulp complex, and establish real possibilities and strategies that favor biocompatibility of the present and new products used in Dentistry, which will certainly benefit clinicians and their patients. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses

Objective. This study aimed to investigate the influence of restoration thickness to the fracture resistance of adhesively bonded Lava (TM) Ultimate CAD/CAM, a Resin Nano Ceramic(RNC), and IPS e. max CAD ceramic.Methods. Polished Lava (TM) Ultimate CAD/CAM (Group L), sandblasted Lava (TM) Ultimate CAD/CAM (Group LS), and sandblasted IPS e.max CAD (Group ES) discs (n=8, phi=10 mm) with a thickness of respectively 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm, and 3.0 mm were cemented to corresponding epoxy supporting discs, achieving a final thickness of 3.5 mm. All the 120 specimens were loaded with a universal testing machine at a crosshead speed of 1 mm/min. The load (N) at failure was recorded as fracture resistance. The stress distribution for 0.5 mm restorative discs of each group was analyzed by Finite Element Analysis (FEA). The results of facture resistances were analyzed by one-way ANOVA and regression.Results. For the same thickness of testing discs, the fracture resistance of Group L was always significantly lower than the other two groups. The 0.5 mm discs in Group L resulted in the lowest value of 1028 (112) N. There was no significant difference between Group LS and Group ES when the restoration thickness ranged between 1.0 mm and 2.0 mm. There was a linear relation between fracture resistance and restoration thickness in Group L (R = 0.621, P < 0.001) and in Group ES (R = 0.854, P < 0.001). FEA showed a compressive permanent damage in all groups.Significance. The materials tested in this in vitro study with the thickness above 0.5 mm could afford the normal bite force. When Lava Ultimate CAD/CAM is used, sandblasting is suggested to get a better bonding. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.