Bond strength of adhesive restorations to Er : YAG laser-treated dentin

Background and Objective: evaluate the adhesion of adhesive restorations with and without a base of resin-modified glass-ionomer cement (RMGIC) to dentin irradiated with Er:YAG laser.Study Design/Materials and Methods: Twenty-four human molar teeth were divided into 6 groups (n=4): G1) 37% Phosphoric acid (PA) + Adhesive system (Ad) + Composite resin (CR); G2) RMGIC + CR; G3) Laser (60mJ-5Hz-20s) + PA + Ad + CR; G4) Laser (60 mJ-5 Hz-20 s) + RMGIC + CR; G5) Laser (100mJ-5Hz-20s) + PA + Ad + CR; G6) Laser (100mJ-5Hz-20s) + RMGIC + CR. Teeth were prepared, restored and cut into specimens, according to the treatment proposed and to methodology for microtensile test. Data were submitted to ANOVA and Tukey statistical tests (alpha=5%).Results:. The mean values for adhesion (MPa) and standard deviation (+/- SD) were: G1) 26.30(+/- 4.50), G2) 5.34(+/- 2.87), G3) 21.16(+/- 6.01), G4) 5.22(+/- 1.52), G5) 22.23(+/- 4.98), G6) 5.25(+/- 3.08).Conclusion: the use of Er:YAG laser did not influence on the restorations adhesion.

Occlusal caries prevention in high and low risk schoolchildren. A clinical trial

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

Microbiological or Chemical Models of Enamel Secondary Caries Compared by Polarized-Light Microscopy and Energy Dispersive X-ray Spectroscopy

Different secondary caries models may present different results. The purpose of this study was to compare different in vitro secondary caries models, evaluating the obtained results by polarized-light microscopy (PLM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Standardized human enamel specimens (n = 12) restored with different materials (Z250 conventional composite resin-CRZ, Freedom polyacid-modified composite resin-CRF, Vitremer resin-modified glass-ionomer-GIV, and Fuji IX conventional glass-ionomer cement-GIF) were submitted to microbiological (MM) or chemical caries models (CM). The control group was not submitted to any caries model. For MM, specimens were immersed firstly in sucrose broth inoculated with Streptococcus mutans ATCC 35688, incubated at 37 degrees C/5% CO(2) for 14 days and then in remineralizing solution for 14 days. For CM, specimens were submitted to chemical pH-cycling. Specimens were ground, submitted to PLM and then were dehydrated, gold-sputtered and submitted to SEM and EDS. Results were statistically analyzed by Kruskall-Wallis and Student-Newman-Keuls tests (alpha = 0.05). No differences between in vitro caries models were found. Morphological differences in enamel demineralization were found between composite resin and polyacid-modified composite resin (CRZ and CRF) and between the resin-modified glass-ionomer and the glass-ionomer cement (GIF and GIV). GIF showed higher calcium concentration and less demineralization, differing from the other materials. In conclusion, the glass-ionomer cement showed less caries formation under both in vitro caries models evaluated. (C) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 90B: 635-640, 2009

Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Reactionary dentinogenesis after applying restorative materials and bioactive dentin matrix molecules as liners in deep cavities prepared in nonhuman primate teeth

Objective: the aim of this in vivo study was to evaluate the response of the pulp-dentin complex following application of resin-modified glass-ionomer cement, calcium hydroxide hard-setting cement and EDTA-soluble preparation of dentine matrix proteins (ESDP) in deep cavities prepared in non-human primate teeth. Methods: Eighteen deep Class V buccal cavities were prepared in premolars of four capuccin monkeys. In Groups 1 and 2, the cavity floor was lined with ESDP or a resin-modified glass-ionomer cement (Vitrebond - 3M ESPE), respectively. In Group 3 (control), the cavity was lined with a hard setting calcium hydroxide cement (Dycal - Dentsply). The cavities were subsequently filled with amalgam. After 6 months, the animals were sacrificed and the teeth were prepared for microscopic assessment. Six-micron thick serial sections were stained with H/E, Masson's trichrome and Brown & Brenn techniques. Results: No inflammatory pulpal response was observed for all experimental and control Groups. However, the amount of reactionary dentin deposition differed between groups in the rank order ESDP (Group 1) > calcium hydroxide (Group 3) > resin-modified glass-ionomer (Group 2). These differences were statistically significant. Conclusions: All materials were biocompatible when applied in deep cavities. ESDP stimulated higher deposition of reactionary dentin matrix than Vitrebond and Dycal.

Sealing evaluation of the cervical base in intracoronal bleaching

Discoloration of non-vital teeth is an esthetic deficiency frequently requiring bleaching treatment. The purpose of this study was to evaluate in vitro the cervical base efficacy in order to prevent or to minimize the leakage along the root canal filling and into the dentinal tubules. Thirty-eight extracted single-root human teeth were used, which were biomechanically prepared, filled, and divided into three experimental groups: G1, a cervical base was applied (3 mm of thickness) below the cemento-enamel junction, with resin-modified glass-ionomer cement (Vitremer); G2, the base was done with glass-ionomer cement (Vidrion R); and G3 (Control), did not receive any material as base. A mixture of sodium perborate and hydrogen peroxide 30% was placed inside the pulp chamber for 3 days, and the access opening was sealed with Cimpat. This procedure was repeated thrice. Soon after this, a paste of calcium hydroxide was inserted into the pulp chamber for 14 days. All teeth were covered with two layers of sticky wax, except the access opening, and immersed in blue India Ink for 5 days. The results did not show statistically significant differences between the three groups concerning the leakage inside the dentinal tubules. Regarding the apical direction, a statistical difference (ANOVA P < 0.05) was observed among the experimental group G1 and control group G3. No statistically significant difference was observed between G2 and G3 groups. Therefore, the placement of a cervical base before internal bleaching procedures is still recommended.

Radiopacity of esthetic restorative materials compared with human tooth structure

Purpose : To compare the radiopacity of 13 restorative materials, (a conventional glass-ionomer cement, three resin-modified glass-ionomer cements, six polyacid-modified resin-based composites, and three resin-based composites) to sound tooth structure. Materials and Methods: 315 specimens were made of the restorative materials (n= 21), of 2 min height and 4.1 mm diameter. Radiographs were taken of the specimens, together with the tooth structure sample and an aluminum step wedge. The radiopacity values of each specimen were taken using a transmission densitometer. Results: ANOVA and Tukey's test (95% level of confidence) revealed that, except for a resin-based composite, a polyacid-modified resin-based composite, a resin-modified glass-ionomer cement and the conventional glass-ionomer cement, all the evaluated restorative materials were more radiopaque than the tooth structure.

Vertical marginal discrepancy of ceramic copings with different ceramic materials finish lines and luting agents: An in vitro evaluation

Statement of problem. Prosthetic restorations that fit poorly may affect periodontal health and occlusion. Studies that have evaluated the accuracy of fit of ceramic restorations before and after cementation assessed primarily intracoronal restorations.Purpose. This in vitro study evaluated the effect of different finish lines, ceramic manufacturing techniques, and luting agents on the vertical discrepancy of ceramic copings.Material and methods. Two stainless steel molars were prepared for complete crowns with 2 different finish lines (heavy chamfer and rounded shoulder); each molar was duplicated to fabricate 90 copings. A total of 180 copings generated 18 groups (n=10 for each finish line-coping material-luting agent combination). Luting agents tested included zinc phosphate, resin-modified glass ionomer (Fuji Plus), and resin composite cements (Panavia F). A metal frame was developed on which to screw the stainless steel model and a ceramic coping; the distance (mum) between 2 predetermined points was measured before and after cementation by a profile projector under a torquing force. A 4-way ANOVA with repeated measurements was performed to assess the influence of each factor in the vertical marginal discrepancy: 3 between-coping factors (finish line-coping material-luting agent) and 1 within-coping factor (before and after cementation) (alpha=.05).Results. Procera copings presented the lowest mean values (P<.05) of vertical marginal discrepancy before and after cementation (25/44 mum) when compared to Empress 2 (68/110 mum) and InCeram Alumina copings (57/117 mum), regardless of any combinations among all finish lines and luting agents tested.Conclusion. Considering each factor separately, the ceramic manufacturing technique appeared to be the most important factor tested for the definitive vertical discrepancy of all-ceramic copings, with lower mean values for Procera copings.

Penetration of 38% hydrogen peroxide into the pulp chamber in bovine and human teeth submitted to office bleach technique

This study evaluated the pulp chamber penetration of peroxide bleaching agent in human and bovine teeth after office bleach technique. All the teeth were sectioned 3 mm apical of the cement-enamel junction and were divided into 2 groups, A (70 third human molars) and B (70 bovine lateral incisors), that were subdivided into A1 and B1 restored by using composite resin, A2 and B2 by using glass ionomer cement, and A3 and B3 by using resin-modified glass ionomer cement; A4, A5, B4, and B5 were not restored. Acetate buffer was placed in the pulp chamber, and the bleaching agent was applied for 40 minutes as follows: A1-A4 and B1-B4, 38% hydrogen peroxide exposure and A5 and B5, immersion into distilled water. The buffer solution was transferred to a glass tube in which leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to analysis of variance and Dunnett, Kruskal-Wallis, and Tukey tests (5%). A higher level of hydrogen peroxide penetrated into the pulp chamber in resin-modified glass ionomer cements in bovine (0.79 +/- 0.61 mu g) and human (2.27 +/- 0.41 mu g) groups. The bleaching agent penetration into the pulp chamber was higher in human teeth for any experimental situation. The penetration of the hydrogen peroxide depends on restorative materials, and under the conditions of this study human teeth are more susceptible to penetration of bleaching agent into the pulp chamber than bovine teeth.

Microleakage evaluation of pit and fissure sealants done with different procedures, materials, and laser after invasive technique

This study evaluated the microleakage of pit and fissure sealants after different surface preparation (invasive technique and laser irradiation) and the use of different materials (fluoride resin-filled sealant, resin-modified glass ionomer cement and adhesive system). Eighty-four pre molars were used in this study, which were divided into seven groups. After the accomplishment of the different treatments, these were submitted to thermocycling process and assess for microleakage by examination under an epifluorescent microscope and scored zero to seven. Two specimens of each group were observed under scanning electron microscope (SEM). The results showed that laser irradiation did not lessen microleakage in pit and fissures when using a filled-resin sealant with fluoride or a resin-modified glass ionomer cement. The use of laser irradiation and adhesive system, followed by a resin-filled sealant with fluoride, showed the lowest microleakage scores in pit and fissures. Comparing this group to the resin-modified glass ionomer cement group, there was statistical significance. The use of a adhesive system decreased microleakage when using a fluoride resin-filled sealant with or without previous laser irradiation; although it was not statistically significant.

Biological response of pulps submitted to different capping materials

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

Shear bond strength fatigue limit of rest seats made with dental restoratives

Purpose: This study compared the shear bond strength (SBS) to enamel of rest seats made with a glass-ionomer cement (Fuji IX GP Fast), a resin-modified glass-ionomer cement (Fuji II LC), and a composite resin (Z100 MP) under monotonic and cyclic loading. Materials and Methods: Rest seats were built up onto the lingual surfaces of 80 intact human mandibular incisors. Specimens (n=10) were stored in distilled water at 37°C for 30 days and subjected to shear forces in a universal testing machine (0.5 mm/min) until fracture. The SBS values were calculated (MPa) using the bonding area (9.62 mm2) delimited by adhesive tags. A staircase approach was used to determine the SBS fatigue limit of each material. Specimens were submitted to either 10,000 cycles (5 Hz) or until specimen fracture. A minimum of 15 specimens was tested for each material. Scanning electron microscopy was used to examine the mode of failure. Data were statistically analyzed with one-way ANOVA and Tukey HSD tests (α = 0.05). Results: Z100 MP yielded higher (p < 0.05) SBS (12.25 MPa) than Fuji IX GP Fast (7.21 MPa). No differences were found between Fuji II LC (10.29 MPa) and the other two materials (p > 0.05). Fuji II LC (6.54 MPa) and Z100 MP (6.26 MPa) had a similar SBS limit. Fuji IX GP Fast promoted the lowest (p < 0.05) SBS fatigue limit (2.33 MPa). All samples showed cohesive failure patterns. Conclusion: Fatigue testing can provide a better means of estimating the performance of rest seats made with dental restoratives.

Influence of bleaching treatment on flexural resistance of hybrid materials.

The aim of this study is to evaluate the flexural resistance of three types of restorative materials: compomer (Freedom), resin-modified glass-ionomer (Vitremer) and composite resin (Esthet-X), observing whether the application of bleaching agent can cause alterations of their flexural properties. Sixty samples were made using a 10 x 1 x 1 mm brass mold, and divided into three groups: G1- Freedom (SDI); G2- Vitremer (3M ESPE); G3- Esthet-X (Dentsply). On half of the samples of each group (10 samples) the bleaching treatment was applied and the other half used as control, was stored in distilled water at a temperature of 37 degrees C. Whiteness HP Maxx bleaching system was applied on the sample surface following the manufacturer's recommendations, simulating the bleaching treatment at the clinic. After this period, a flexural strength (three-point bending) test was conducted using (EMIC DL 1000) machine until the samples fractured. The data were submitted to ANOVA and Tukey tests. Of the restorative materials studied, G3-(87.24 +/- 31.40 MPa) presented the highest flexural strength, followed by G1-(61.67 +/- 21.32 MPa) and G2-(61.67 +/- 21.32 MPa). There was a statistical difference in flexural strength after the bleaching treatment. It was concluded that the use of a beaching agent can promote significant alteration of the flexural strength of these restorative materials.

Effects of three restorative techniques in the bond strength and nanoleakage at gingival wall of Class II restorations subjected to simulated aging

Objective: To evaluate the effects of simulated aging in bond strength and nanoleakage of class II restorations using three different restorative techniques. Materials and methods: Class II preparations (n = 12) were restored using: FS - composite resin Filtek Supreme Plus (3M/ESPE); RMGIC + FS - resin-modified glass ionomer cement Vitrebond Plus (3M/ESPE) + FS; and FFS + FS - flowable composite resin Filtek Supreme Plus Flowable (3M ESPE) + FS. The teeth were assigned into two groups: Control and Simulated Aging - Thermal/Mechanical cycling (3,000 cycles, 20-80 °C/500,000 cycles, 50 N). From each tooth, two slabs were assessed to microtensile bond strength test (μTBS) (MPa), and two slabs were prepared for nanoleakage assessment, calculated as penetration along the restoration margin considering the penetration length (%) and as the area of silver nitrate particle deposition (μm2). Data were analyzed by two-way analysis of variance (ANOVA) followed by Tukey's post hoc test (p < 0. 05). Results: FS presented the highest μTBS to dentin (22. 39 ± 7. 55 MPa) after simulated aging, while the presence of flowable resin significantly decreased μTBS (14. 53 ± 11. 65 MPa) when compared to no aging condition. Both control and aging groups of RMGIC + FS presented the highest values of silver nitrate penetration (89. 90 ± 16. 31 % and 97. 14 ± 5. 76 %) and deposition area (33. 05 ± 12. 49 and 28. 08 ± 9. 76 μm2). Nanoleakage was not affected by simulated aging. Conclusions: FS presented higher bond strength and lower nanoleakage and was not affected by simulated aging. Use of flowable resin compromised the bond strength after simulated aging. Clinical relevance: The use of an intermediate layer did not improve the dentin bond strength neither reduced nanoleakage at the gingival margins of class II restorations under simulated aging conditions. © 2012 Springer-Verlag.

Avaliações clínica e clínica/fotográfica de restaurações adesivas, realizadas em lesões cervicais não cariosas: efeitos dos materiais restauradores, tipos e tempos de avaliação

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