Preparos dentais para coroas totais anteriores cerâmicas

The aim of this study is to describe, illustrate and discuss a simple, effective and rational method for preparing anterior all-ceramic restorations. This procedure uses a reduced number of diamond burs and a few clinical steps. The biological, mechanical, functional and aesthetic principles are obtained in a reasonable manner, regarding the requirements’ supported by the contemporary aesthetic dentistry. At the end of reading, it is expected that the professionals understand the design of the axial and cervical dental walls. Finally, the dental preparations will be made in a rapid and efficient manner. Despite the citation of specific diamond burs, it is expected that the reader use them as a reference. The understanding of their geometric configuration and volume are more important than their manufacturer’s reference number. Other manufacturers have diamond burs with the same geometric configuration of those recommended in this technique. Thus, the clinical professional must select the diamond points according to their manufacturer of choice.

Sistemas cerámicos puros parte 1: una evolución basada en la composicíon

The continuing advances in technology, dental materials and equipment have contributed significantly to improve the level of esthetic dentistry today. Among these innovations, development of pure ceramic restorations has evolved to give different alternatives. Dental ceramics have presented a rapidly technological changing to improve mechanical and optical properties. Currently there are several systems of metal free ceramics with excellent mechanical and optical properties, for making crowns and plurals. These modern systems are presented with various compositions and different preparation techniques, making these more versatile. Within this perspective, the dental market offers a huge range of new indirect and metal-free materials for prostheses, providing new options, plus also new questions to decide among the available alternatives. The aim of this review is take a view of the different ceramic systems in terms of its composition and different techniques of production.

Sistemas cerámicos puros parte 2: materiales, propiedades ópticas y consideraciones clínicas

While dentistry continues to advance, the aesthetic techniques have evolved in proceedings more effective, functional and biocompatible. Meanwhile, cosmetic dentistry has become a bit more complex and technically difficult. With improvement of the properties (physical and optical) of the ceramics and the establishment of a working protocol, ceramic restorations have become increasingly popular. Currently there are several ceramic systems have excellent optical properties such as opalescence, fluorescence, translucency, chromaticity, which allow the restoration to mimic the tooth structure. From the physical point of view has restored biomechanical integrity and strengthening the remaining tooth structure. All this has led the profession to experience the use of new ceramic systems ranging from conventional feldspathic ceramics to modem ceramic reinforced, injected or computer-aid made. The material selection should be based on clinical need, aesthetic and functional requirements, restoration site, prosthetic design and laboratory techniques. In this article we will deal with the characteristics of the materials, their optical properties and clinical considerations for proper selection.

Correlación entre diferentes métodos de evaluación de color en el clareamiento dental. Correlation between different methods for co

The aim of this study was to evaluate the correlation of color change on bleaching tooth through delta E (ΔE) by the spectrophotometer Spectroshade (SS) and digital program Scanwhite (SW). Methods: 25 patient volunteers were recruited from Operative Dentistry at Universidad de Chile Dental School, between 18 to 30 years, with good oral hygiene. Exclusion criteria: Previous experienced tooth bleaching, anterior restorations, cervical lesions, pain dental, pregnant patient, stained teeth, malposition of the teeth and periodontal pathology. The bleaching was made in two sessions with three different bleaching systems which were randomly. The assessment of color change through ΔE was made on the two upper central incisors (N=50) by the SS and SW. The color in the same teeth were measured before (T0) and after (T1) of the bleaching treatment. Data were analyzed using test Spearman correlation coefficient (Rho) with a significant level of 95%. Results: The results showed a positive and significant correlation (0.676), with a statistically significant difference (p<0.05). Conclusion: There is correlation in the measurement of color change on bleaching tooth by SS and SW.

Restoration of endodontically treated teeth

The restoration of endodontically treated teeth is one of the most challenging situations of the dentist`s clinical practice, because it involves procedures related to several areas, such as Endodontics, Operative Dentistry, and Prosthetics. These restorations aim to replace the structures lost during endodontic surgery and access to both the pulp chamber and root canal system during the instrumentation, as well as the removal of the carious tissue and temporary restorations. It is also important to remember that the prognosis of endodontically treated teeth depends not only on endodontic treatment success itself, but also on the amount of remnant tooth tissue and the definitive restoration that will be placed onto the dental element.

Cuspal movement related to different polymerization protocols

Objective: The aim of this study to investigate the effects of different polymerization protocols on the cuspal movement in class II composite restorations. Materials and methods: Human premolar teeth were prepared with class II cavities and then restored with composite and three-step and two-step etch-and-rinse adhesive systems under different curing techniques (n = 10). It was used a lightemittingdiode curing unit and the mode of polymerization were: standard (exposure for 40 seconds at 700 mW/cm2), pulse-delay (initial exposure for 6 seconds at 350 mW/cm2 followed by a resting period of 3 minutes and a final exposure of 37 seconds at 700 mW/cm2) and soft-start curing (exposure 10 seconds at 350 mW/cm2 and 35 seconds at 700 mW/cm2). The cuspal distance (µm) was measured before and after the restorative procedure and the difference was recorded as cuspal movement. The data were submitted to two-way ANOVA and Bonferroni test (p < 0.05). Results: The type of adhesive system did not influenced the cuspal movement for all the curing methods. Standard protocol showed the highest values of cuspal movement and was statistically different from the pulse-delay and soft-start curing modes. Conclusion: Although the cuspal displacement was not completely avoided, alternative methods of photocuring should be considered to minimize the clinical consequences of composites contraction stress.

Clinical protocol for esthetic restoration using a self-etching adhesive

The advent of new adhesive systems is making techniques and clinical protocols to become faster and simpler, however it does not reduce the importance of knowledge of the properties, characteristics and interaction of dental materials with the tooth structure. Among the adhesives that have recently emerged, highlight the self-etching systems, especially the two-step selfetching, in which the acid primer is available in a separate bottle from the adhesive. These adhesives have shown good results for bond strength, microleakage and postoperative sensitivity, being an option for direct adhesive restorations in anterior teeth. This way, the present case report describes the step-by-step making of a class IV restoration in an upper right central incisor using atwo-step adhesive system, obtaining satisfactory results.

Fluorescence Level of Composites Assessed by Computer Processing of Digital Images - ScanWhite

The human dentition is naturally translucent, opalescent and fluorescent. Differences between the level of fluorescence of tooth structure and restorative materials may result in distinct metameric properties and consequently perceptible disparate esthetic behavior, which impairs the esthetic result of the restorations, frustrating both patients and staff. In this study, we evaluated the level of fluorescence of different composites (Durafill in tones A2 (Du), Charisma in tones A2 (Ch), Venus in tone A2 (Ve), Opallis enamel and dentin in tones A2 (OPD and OPE), Point 4 in tones A2 (P4), Z100 in tones A2 ( Z1), Z250 in tones A2 (Z2), Te-Econom in tones A2 (TE), Tetric Ceram in tones A2 (TC), Tetric Ceram N in tones A1, A2, A4 (TN1, TN2, TN4), Four seasons enamel and dentin in tones A2 (and 4SD 4SE), Empress Direct enamel and dentin in tones A2 (EDE and EDD) and Brilliant in tones A2 (Br)). Cylindrical specimens were prepared, coded and photographed in a standardized manner with a Canon EOS digital camera (400 ISO, 2.8 aperture and 1/ 30 speed), in a dark environment under the action of UV light (25 W). The images were analyzed with the software ScanWhite©-DMC/Darwin systems. The results showed statistical differences between the groups (p < 0.05), and between these same groups and the average fluorescence of the dentition of young (18 to 25 years) and adults (40 to 45 years) taken as control. It can be concluded that: Composites Z100, Z250 (3M ESPE) and Point 4 (Kerr) do not match with the fluorescence of human dentition and the fluorescence of the materials was found to be affected by their own tone.

Indirect resin onlay cemented with self-adhesive resin cement: a comprehensive clinical overview

Advances in adhesive technology and esthetic dental materials have permitted clinicians to perform conservative preparation of the dentition for onlay restorations. Indirect resin onlays are a great alternative to dental crowns for reestablishment the function and esthetic in teeth with great destruction.

Interactions between restorative dentistry and periodontics: preparation and cementation of an onlay in Empress (Part III)

The relentless pursuit by cosmetic dentistry brought the evolution of materials ceramics. The IPS-Empress system was upgrading of indirect restorations based on lithium disilicate. The ceramic restoration posterior allow a new esthetic approach due to its translucency and resistance without any weakening of the remaining dental element, being an option more conservative when compared to conventional prosthetic restorations.

Surface roughness analysis of dental ceramics treated with hydrofl uoric acid and aluminum oxide jet

The aim of this study was to evaluate the surface roughness of 5 indirect restorative materials treated with hydrofluoric acid to 10%, with aluminum oxide jet and a combination of both. The specimens was prepared with 10 mm in diameter and 2 mm thickness, divided into fi ve groups: (1) Ceromer (CeseadII-Kuraray), (2) Leucite crystals ceramics (IPS EmpressIIIvoclarforcasket), (3) glass ceramic with fluorapatite (IPS D. Sign-Ivoclar), (4) lithium disilicate ceramic (IPS Empress II-Ivoclar restorations), (5) ceramics (Cergogold-Degussa). For all groups were performed the controls, and the surfaces with the 3 types of treatment. For testing roughness used the rugosimeter Taylor/Hobson-Precision, model form tracerSV-C525 high sensitivity. After confi rmation of variance analysis with a signifi cance level of 1% (p < 0.01), there was equality between the average roughness of materials from groups 1, 3 and 5, and the group 2 was different from the others. It was also found that the ceramics of the group 5 behaved similar to group 4. However the lowest average roughness was observed in group 2 ceramic. In the evaluation between the types of treatment, the aluminum oxide jet and associations and blasting with hydrofl uoric acid were similar, and different isolated hydrofl uoric acid, and 3 types of treatment signifi cantly higher than the control group. All treatments promoted superfi cial alterations in all tested materials.

Reabilitação estética do sorriso por meio do sistema cerâmico dissilicato de lítio: relato de caso

The reestablishment of a harmonious smile through dental ceramics, when properly conducted and with specific indications, can achieve extremely predictable results. For aesthetic and functional rehabilitation, many ceramic materials can be used such as zirconia, leucite, alumina, feldspar, and lithium disilicate. Among these materials the lithium disilicate stands out due to the following characteristics: its resistance to wear, to chemical attack, high temperatures and oxidation; low electrical conductivity; near zero thermal expansion; good optical properties and biocompatibility with periodontal; excellent esthetics; color stability and reinforcement of tooth structure. The indications for the use of lithium disilicate are not limited to multiple facets of teeth in cases where there was no favorable response to tooth whitening, and also comprehend teeth with multiple restorations, diastema closure, shape alteration, and dental contouring, replacement of missing or fractured teeth, among others. The versatility of lithium disilicate ceramics allows its utilization in several clinical situations. The concomitant use of lithium disilicate for veneers and over metal has satisfactory aesthetic results, as reported in the present studying cases that require both aesthetics and resistance.

Conservative treatment for amelogenesis imperfecta: a case report

Amelogenesis imperfecta is a hereditary condition that can alter the thickness, color, and shape of tooth enamel. Recent adhesive materials and techniques have provided less invasive treatment options. This case report presents the treatment of a patient whose anterior teeth had color alterations, white spots, pits, and shape defects. Using a more conservative technique, the mandibular and maxillary anterior teeth were restored using veneer direct composite restorations. After 6 years, the restorations demonstrated no deterioration, and no pathology was seen in association with the rehabilitation.

Can repair increase the longevity of composite resins? Results of a 10-year clinical trial

The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. Methods Twenty-eight patients aged 18–80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were “clinically judged” to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n = 25) or Replacement (n = 25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. Results Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p > 0.05), secondary caries (SC) (p > 0.05), anatomy (A) (p < 0.05), and colour (C) (p > 0.05). Conclusions Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. Clinical significance The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.

Sealing composite with defective margins, good care or over treatment? results of a 10-year clinical trial

Purpose: The objective of this study was to clinically evaluate sealed composite restorations after 10 years and compare their behavior with respect to controls. Methods and Materials: The cohort consisted of 20 patients aged 18 to 80 years with 80 composite restorations. All participants in the sealing and no-treatment groups presented with clinical features for the marginal adaptation that deviated from the ideal and were rated Bravo (United States Public Health Service criteria). Composites with Alfa values for the marginal adaptation were used as the positive control. Results: The marginal adaptation behavior was similar between the sealing and control (+) groups, with a high frequency of Bravo values in the 10th year (80% and 51%, respectively). Most of the no-treatment (-) group maintained the Bravo values (91%) for 10 years, although some restorations (9%) progressed to Charlie values. The anatomy parameter differed significantly between the first and 10th years, with deterioration in all three groups (p,0.05). The secondary caries parameter had a similar behavior in the three groups (p.0.05). Conclusions: Sealing the margins of the composite resin restorations had no significant effect compared with the control groups, under the conditions of this study. Sealing the restorations substantially improved the marginal staining and marginal adaptation parameters, although by the tenth year they were similar to the group without intervention.