Évaluation de l’effet de "Streptococcus mutans" sur la qualité du fini de surface de matériaux dentaires de restauration

Objectif : Évaluer l’impact de l’exposition d’un biofilm de Streptococcus mutans (S. mutans) pendant une période de 28 jours sur la rugosité de surface de matériaux de restauration dentaire. Matériel et méthode : Les matériaux testés étaient : six résines composites (fluide, bulk-fill fluide, microparticules, nanoparticules, microhybride et nanohybride), un verre ionomère conventionnel, un verre ionomère modifié à la résine, de l’amalgame, du disilicate de lithium et de la porcelaine feldspathique renforcie de cristaux de nanoleucite. Cent soixante-dix-sept disques de 5 mm de diamètre par 2 mm d’épaisseur ont été fabriqués et polis selon une méthode standardisée. Des répliques ont été fabriquées puis réservées pour les mesures de rugosité. Les échantillons ont été stérilisés puis placés dans un milieu de culture pendant 28 jours, avec S. mutans pour les groupes tests et sans S. mutans pour leurs contrôles. Le milieu de culture a été renouvelé toutes les 48 heures. De nouvelles répliques des échantillons ont été fabriquées. Finalement, la rugosité de la surface avant et après l’exposition au biofilm a été évaluée sur les répliques à l’aide d’un profilomètre. Les analyses statistiques ont été effectuées à l’aide d’un modèle d’analyse de variance à deux facteurs. Résultats : Aucune différence statistiquement significative n’a été notée entre la rugosité initiale et finale des groupes tests et des groupes contrôles (p < 0,05). Conclusion : Dans les limites de cette étude in vitro, l’exposition à un biofilm de S. mutans pendant 28 jours n’a pas démontré avoir d’impact sur la rugosité des matériaux testés.

Comparação de materiais usados na confeção de facetas dentárias

A demanda na procura da reabilitação estética é um dos focos da história da humanidade ao longo das eras, mas que teve a sua acentuação nestes últimos dois séculos. Sendo a face um dos pontos que nos permite avaliar esteticamente uma pessoa, cabe ao médico dentista, como um dos profissionais que trabalha nessa zona do corpo humano, avaliar e procurar satisfazer as necessidades estéticas da população. Assim, por parte dos profissionais de Medicina Dentária, tem de haver uma procura constante para a satisfação das exigências estéticas, não só no conhecimento como no aprimoramento da técnica. Nos últimos tempos, com a necessidade de desenvolvimento de materiais para colmatar a cada vez maior busca para a perfeição estética, as facetas surgiram como tratamento de excelência. O presente trabalho teve como objectivo a comparação entre resina composta e cerâmica, na elaboração de restaurações estéticas. Para os dois tipos de materiais foram avaliados a estética e o comportamento biomecânico. Foram comparados benefícios e desvantagens, contra-indicações, indicações, plano de tratamento, diagnóstico e procedimentos clínicos dos dois materiais, utilizados na confecção das facetas cerâmicas e de resina composta. Foram utilizados os seguintes parâmetros de comparação: biocompatibilidade, adaptação marginal, preparação, resistência, cor, acabamento, potencial de reparação, custo e estética. A utilização de facetas cerâmicas tem sido um dos principais focos de desenvolvimento da Medicina Dentária no âmbito científico. A sua utilização permite uma maior predictibilidade e uma maior longevidade clínica. A sua qualidade estética, resistência à fractura, biodisponibilidade e estabilidade de cor, são as suas maiores vantagens na utilização clínica. Em sentido inverso, as facetas de resina composta apresentam menor custo, maior resistência à abrasão, possibilidade de reparação fácil e menor desgaste de estrutura dentária durante a sua preparação. Contudo apresentam menor estabilidade de cor. Portanto, torna-se esclarecedor que a escolha do material a utilizar na confecção de facetas, deve ser adaptada às especificidades de cada caso.

Clinical evaluation of two materials in the restoration of abfraction lesions

Aim: To evaluate the clinical performance of a composite resin (CR) and a resin-modified glassionomer cement (RMGIC) for the treatment of abfraction lesions. Methods: Thirty patients with abfraction lesions in at least two premolar teeth were selected and invited to participate in this study. All restorations were made within the same clinical time frame. One tooth was restored with CR Z100TM (3M, St. Paul, MN, USA), and the other was restored with RMGIC VitremerTM (3M). The restorations were assessed immediately and 1, 6 and 12 months after the restoration, using modified US Public Health Service (USPHS) criteria: marginal integrity, marginal discoloration, wear, retention, secondary caries and hypersensitivity. The statistical analysis was based on Friedman ANOVA test and Mann-Whitney test, considering p<0.05 for statistical significance. Results: Both materials demonstrated satisfactory clinical performance after one year. In the individual analysis of each material, there was a significant difference (p<0.05) in the criteria marginal integrity and wear, for both CR and RMGIC. RMGIC exhibited more damage one year after the restoration. Comparing both materials, it was found a significant difference only for marginal discoloration, while the RMGIC restorations showed the worst prognosis after a year of evaluation. There was no significant difference in the number of retentions, caries or hypersensitivity between CR and RMGIC. Conclusions: It was concluded that CR exhibited the best clinical performance according to the cost-effectiveness and evaluation criteria used in this study.

Novos monômeros obtidos a partir do metacrilato de glicidila, bisfenol A e 4, 4 isopropilidenodicicloexanol : síntese, caracterização estrutural e propriedades de compósitos para utilização em resinas de restauração dental

Nowadays, composite resins are the direct restorative materials more important in dental clinical performance, due to their versatility and aesthetic excellence. Bis-GMA (2,2-bis[4(2-hydroxy-3-metacryloxypropoxy)phenil]propane) is the base monomer more frequently used in restorative composite resins. However, this monomer presents some disadvantages, such as high viscosity and two aromatic rings in its structure that can promote allergic reactions to the humans. In this work, the main purpose was to synthesize new monomers from glycidyl methacrylate to use in dental restorative materials. Structural characterization of the monomers was carried out through FTIR and NMR 1H, and eight composites were produced from the new monomers, by addition of silane-treated alumino silicate particles (inorganic filler) and a photocuring system (camphorquinone and ethyl 4-dimethylaminebenzoate). The composites were analyzed by environmental scanning electronic microscopy and the water sorption and solubility, compressive strength and elastic modulus were determined. A commercial composite resin [Z100 (3M)] was used to comparison effect. The new composites presented general characteristics similar to the commercial ones; however, they didn t present the properties expected. This behavior was attributed to the lower degree of monomer reaction and to the granulometry and size distribution of the mineral filler in the polymeric matrix

Considerations on indirect adhesive restorations at the material and tooth interfaces

Objective: Lithium-silicate (LiSi) ceramic is nowadays widely used in dentistry. However, for the longevity of LiSi indirect restorations, it is important to pretreat the material and the dental substrate adequately. However, is not certain how the simplification of the manufacturing and conditioning procedures influences the bonding performances of LiSi ceramic restorations. Accordingly, the aims of this thesis were to investigate the effect of: 1) different LiSi ceramic surface decontamination procedures on the shear bond strength (SBS) to resin composite; 2) different types of lithium-disilicate (LiDi) (pressed vs CAD-CAM) on SBS to resin composite; 3) an experimental metal salt-based zirconium oxynitrate etchant [ZrO(NO3)2] on bonding performances to dentin. Materials and Methods: SBS test was used to investigate the influence of different cleaning protocols applied, or different processing techniques (CAD or PRESS) on the bond strength to composite resin. The third study tackled the interface between restorative materials and dentin, and investigated the microtensile bond strength test (µTBS), nanoleakage expression analysis (NL), gelatin zymography and in situ zymography of dentin conditioned with an experimental metal salt-based zirconium oxynitrate etchant [ZrO(NO3)2]. Results: MEP showed comparable bond strength to the double HP etching and higher compared to other groups. BS of press LiSi to composite was higher than that of CAD/CAM LiSi. ZON pretreatment increased bond strength to dentin when used with a universal adhesive, and inhibited dentinal endogenous enzymes. Conclusions: While simplification of the LiSi conditioning and cleaning procedures seems to yield bond strength comparable to the traditional procedures, it could be recommended in the clinical practice. However, pressed LiSi still seems to perform better in terms of bond strength compared to the CAD/CAM LiSi. Further, the novel ZON etchant seems to perform better compared to the traditional phosphoric dentin etching.

Influence of irradiant energy on degree of conversion, polymerization rate and shrinkage stress in an experimental resin composite system

Objective. This study evaluated the degree of conversion (DC), maximum rate of cure (R(p)(max)), and polymerization stress (PS) developed by an experimental dental composite subjected to different irradiant energies (3,6,12, 24, or 48J/cm(2)) under constant irradiance (500 mw/cm(2)). Methods. DC and R(p)(max) were monitored for 10 min on the bottom surface of 2-mm thick disks and on 150-mu m thick films (representing the top of the specimen) using ATR-FTIR. PS was monitored for 10 min in 2-mm thick disks bonded to two glass rods (O = 5 mm) attached to a universal testing machine. One-way ANOVA/Tukey tests were used and differences in DC and R(p)(max) between top and bottom surfaces were examined using Student`s t-test. Statistical testing was performed at a pre-set alpha of 0.05. Results. For a given surface, DC showed differences among all groups, except at the top between 24 and 48 J/cm(2). R(p)(max) was similar among all groups at the same surface and statistically higher at the top surface. PS also showed significant differences among all groups. Data for 48 J/cm(2) were not obtained due to specimen failure at the glass/composite interface. Significance. Increases in irradiant exposure led to significant increases in DC and PS, but had no effect on R(p)(max) (c) 2008 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Influence of curing rate on softening in ethanol, degree of conversion, and wear of resin composite

Purpose: To investigate the effect of curing rate on softening in ethanol, degree of conversion, and wear of resin composites. Methods: With a given energy density and for each of two different light-curing units (QTH or LED), the curing rate was reduced by modulating the curing mode. Thus, the irradiation of resin composite specimens (Filtek Z250, Tetric Ceram, Esthet-X) was performed in a continuous curing mode and in a pulse-delay curing mode. Wallace hardness was used to determine the softening of resin composite after storage in ethanol. Degree of conversion was determined by infrared spectroscopy (FTIR). Wear was assessed by a three-body test. Data were submitted to Levene`s test, one and three-way ANOVA, and Tukey HSD test (alpha= 0.05). Results: Immersion in ethanol, curing mode, and material all had significant effects on Wallace hardness. After ethanol storage, resin composites exposed to the pulse-delay curing mode were softer than resin composites exposed to continuous cure (P< 0.0001). Tetric Ceram was the softest material followed by Esthet-X and Filtek Z250 (P< 0.001). Only the restorative material had a significant effect on degree of conversion (P< 0.001): Esthet-X had the lowest degree of conversion followed by Filtek Z250 and Tetric Ceram. Curing mode (P= 0.007) and material (P< 0.001) had significant effect on wear. Higher wear resulted from the pulse-delay curing mode when compared to continuous curing, and Filtek Z250 showed the lowest wear followed by Esthet-X and Tetric Ceram. (Am J Dent 2011;24:115-118).

Deposition of Lead and Cadmium Released by Cigarette Smoke in Dental Structures and Resin Composite

Cigarette smoke is a significant source of cadmium, lead, and toxic elements, which are absorbed into the human organism. In this context, the aim of this study was to investigate in vitro the presence of toxic elements, cadmium, and lead deriving from cigarette smoke in the resin composite, dentine, and dental enamel. Eight cylindrical specimens were fabricated from resin composite, bovine enamel, and root dentin fragments that were wet ground and polished with abrasive paper to obtain sections with 6-mm diameter and 2-mm thickness. All specimens were exposed to the smoke of 10 cigarettes/day during 8 days. After the simulation of the cigarette smoke, the specimens were examined with scanning electron microscopy (SEM) and the energy-dispersive X-ray analysis. In the photomicrographic analysis in SEM, no morphological alterations were found; however, the microanalysis identified the presence of cadmium, arsenic, and lead in the different specimens. These findings suggest that the deposition of these elements derived from cigarette smoke could be favored by dental structures and resin composite. Microsc. Res. Tech. 74:287-291, 2011. (C) 2010 Wiley-Liss, Inc.

Development of Craniofacial Bone Defect Reconstruction Implant Based on Fibre-Reinforced Composite with Photopolymerisable Resin Systems. Experimental studies in vitro and in vivo.

Reconstruction of defects in the craniomaxillofacial (CMF) area has mainly been based on bone grafts or metallic fixing plates and screws. Particularly in the case of large calvarial and/or craniofacial defects caused by trauma, tumours or congenital malformations, there is a need for reliable reconstruction biomaterials, because bone grafts or metallic fixing systems do not completely fulfill the criteria for the best possible reconstruction methods in these complicated cases. In this series of studies, the usability of fibre-reinforced composite (FRC) was studied as a biostable, nonmetallic alternative material for reconstructing artificially created bone defects in frontal and calvarial areas of rabbits. The experimental part of this work describes the different stages of the product development process from the first in vitro tests with resin-impregnated fibrereinforced composites to the in vivo animal studies, in which this FRC was tested as an implant material for reconstructing different size bone defects in rabbit frontal and calvarial areas. In the first in vitro study, the FRC was polymerised in contact with bone or blood in the laboratory. The polymerised FRC samples were then incubated in water, which was analysed for residual monomer content by using high performance liquid chromatography (HPLC). It was found that this in vitro polymerisation in contact with bone and blood did not markedly increase the residual monomer leaching from the FRC. In the second in vitro study, different adhesive systems were tested in fixing the implant to bone surface. This was done to find an alternative implant fixing system to screws and pins. On the basis of this study, it was found that the surface of the calvarial bone needed both mechanical and chemical treatments before the resinimpregnated FRC could be properly fixed onto it. In three animal studies performed with rabbit frontal bone defects and critical size calvarial bone defect models, biological responses to the FRC implants were evaluated. On the basis of theseevaluations, it can be concluded that the FRC, based on E-glass (electrical glass) fibres forming a porous fibre veil enables the ingrowth of connective tissues to the inner structures of the material, as well as the bone formation and mineralization inside the fibre veil. Bone formation could be enhanced by using bioactive glass granules fixed to the FRC implants. FRC-implanted bone defects healed partly; no total healing of defects was achieved. Biological responses during the follow-up time, at a maximum of 12 weeks, to resin-impregnated composite implant seemed to depend on the polymerization time of the resin matrix of the FRC. Both of the studied resin systems used in the FRC were photopolymerised and the heat-induced postpolymerisation was used additionally.

Optimal distance of the light-curing tip for light transmission through the resin composite

Hammaslääketieteessä käytetettävien komposiittien valonläpäisevyys vaihtelee. Samoin LED-valokovettimet eroavat toisistaan valotehonsa ja muotoilunsa perusteella. On yleisesti tiedossa, että valokovettimesta tulevan valon intensiteetti pinta-alayksikköä kohden heikkenee, kun kovettimen etäisyys kasvaa. Toisaalta ei ole tiedossa, miten valokovetettavan kohteen ja valokovettimen kärjen väliin sijoitettu materiaali tarkalleenottaen vaikuttaa valon intensiteettiin eri etäisyyksiä käytettäessä. Tämän tutkimuksen tarkoituksena on selvittää, miten valokovetettavan kohteen ja valokovettimen kärjen väliin asetettava etukäteen polymerisoitu materiaali vaikuttaa valon intensiteettiin eri etäisyyksillä. Tutkimus suoritettiin käyttämällä kahta eri valokovetinta. Jotta etäisyyden vaikutusta valotustehoon voitiin demonstroida, vaihdettiin kovettimen etäisyyttä sensorista 0,2,4,6,8,10mm välillä. Valotehot rekisteröitiin MARC resin calibrator -laitteella. Sensorin ja valokovettimen kärjen väliin asetettavat erilaiset komposiittilevyt olivat valmiiksi kovetettuja,1mm paksuisia, filleripitoisuuksiltaan neljää erilaista muovia. Valotehot rekisteröitiin jokaiselta etäisyydeltä komposiitin ollessa sensorin päällä. Rinnakkaisesti verrattiin myös etäisyyden vaikutusta valotehoon ilman esikovetettua materiaalia kovettimen kärjen ja valoa mittaavan sensorin välissä. Vertailun suorittamiseksi laskettiin intensiteettisuhdeluku muovillisen ja muovittoman arvon välillä aina tietyllä etäisyydellä Valokovettimen kärjen etäisyyden kasvattaminen sensorista (eli valokovetettavasta kohteesta) odotusten mukaisesti pienensi valotehoa. Laittamalla sensorin ja kovettimen väliin komposiittilevy, valoteho pieneni odotetusti vielä enemmän. Tutkittaessa intensiteettisuhdetta (valoteho muovin kanssa : valoteho ilman muovia) kuitenkin huomattiin, että 4-6mm:n kohdalla suhdeluku oli suurempi kuin 0,2,8 ja 10mm kohdalla. Johtopäätöksenä oli, että suurin mahdollinen valokovetusteho saavutetan laittamalla kovetuskärki mahdollisimman lähelle kohdetta. Jos valokovetettavan kohteen ja valokovettimen kärjen välissä oli kiinteä komposiittipalanen, suurin mahdollinen valokovetusteho kohteeseen saavutetaan edelleen laittamalla kovetuskärki kiinni muoviin. Jos etäisyyttä muovin pinnasta sen sijaan kasvatettiin, valokovetusteho ei laskenutkaan niin nopeasti kuin oli odotettu. Tämä voi liittyä siihen, että tehokkaan valokeilan halkaisijan koko on suurempi verrattuna komposiitin sekä sensorin halkaisian kokoon. Toiseksi on arvioitu, että resiinikomposiitin täyteaineet voisivat fokusoida läpi kulkevaa valoa sensoriin. Se, pitääkö tämä ilmiö paikkansa, vaatii kuitenkin enemmän tutkimusta

Influence of Post and Resin Cement on Stress Distribution of Maxillary Central Incisors Restored with Direct Resin Composite

The current study evaluated the influence of two endodontic post systems and the elastic modulus and film thickness of resin cement on stress distribution in a maxillary central incisor (MCI) restored with direct resin composite using finite element analysis (FEA). A three-dimensional model of an MCI with a coronary fracture and supporting structures was performed. A static chewing pressure of 2.16 N/mm(2) was applied to two areas on the palatal surface of the composite restoration. Zirconia ceramic (ZC) and glass fiber (GF) posts were considered. The stress distribution was analyzed in the post, dentin and cement layer when ZC and GF posts were fixed to the root canals using resin cements of different elastic moduli (7.0 and 18.6 GPa) and different layer thicknesses (70 and 200 mu m). The different post materials presented a significant influence on stress distribution with lesser stress concentration when using the GF post. The higher elastic modulus cement created higher stress levels within itself. The cement thicknesses did not present significant changes.

Effect of fluid resins on the surface roughness and topography of resin composite restorations analyzed by atomic force microscope

The aim of the study was to verify the influence of surface sealants on the surface roughness of resin composite restorations before and after mechanical toothbrushing, and evaluate the superficial topography using atomic force microscope. Five surface sealers were used: Single Bond, Opti Bond Solo Plus, Fortify, Fortify Plus and control, without any sealer agent. The lowest values of surface roughness were obtained for control, Single Bond and Fortify groups before toothbrushing. Fortify and Fortify Plus were the sealer agents that support the abrasive action caused by the toothbrushing although Fortify Plus group remained with high values of surface roughness. The application of specific surface sealants could be a useful clinical procedure to maintain the quality of resin-based composite restorations. (C) 2010 Elsevier Ltd. All rights reserved.

Assessing the surface roughness of a posterior resin composite: effect of surface sealing

This study assessed the in vitro influence of surface sealing on the surface roughness of a posterior resin composite before and after tooth-brushing. Thirty. specimens (13 nun diameter x 1 mm high) were fabricated from Filtek-P60 resin composite and randomly assigned to three groups (n=10): a non-sealed control and two groups sealed with one of the tested materials-a surface-penetrating sealant (Protect-it!-PI) and a one bottle adhesive system (Single Bond-SB). The samples were subjected to a surface roughness reading to determine the initial roughness, then submitted to simulated toothbrushing with 35,600 cycles for 100 minutes. Specimens were then cleaned and a post-abrasion surface roughness reading accomplished. Means (pm), recorded before (B) and after (A) toothbrushing, and standard deviations were: Control-(B): 0.032 (+/-0.005), (A): 0.054 (+/-0.005); PI-(B): 0.034 (+/-0.005), (A): 0.060 (+/-0.034); SB (B): 0.031 (+/-0.004), (A): 0.047 (+/-0.007). Data were tabulated and submitted to two-way ANOVA. No statistically significant difference was observed when the control and experimental groups were compared. However, a significant difference (p<0.05) was found between the measurements performed before and after toothbrushing. Based on these results, it may be concluded that using either a surface penetrating sealant or a one bottle adhesive system did not provide the optimization of superficial integrity. The use of a dentifrice and toothbrush resulted in significant alterations to the surface smoothness of the resin composite.