Ameloblastic fibro-odontoma: A case report

Ameloblastic fibro-odontoma (AFO) is a rare, benign, slow-growing odontogenic tumor, generally asymptomatic and more prevalent in children and adolescents. We report a case of AFO in the mandible of an eight-year-old Caucasian male patient, and review the literature. Intraoral examination revealed a swelling extending from the deciduous second molar to the retromolar triangle, covered with normal mucosa. A panoramic radiograph showed a large, well-demarcated radiolucency with radiopaque areas. The provisional diagnosis was of AFO, and so an incisional biopsy was performed. Histologically, the lesion was composed of connective tissue resembling the dental papilla, with epithelial strands or islands, as well as denticles and amorphous masses of enamel and dentin consistent with a diagnosis of AFO. Surgical excision and curettage of the lesion were performed. The patient has been monitored for eight years and the lesion has not recurred.

Influence of prior 810-nm-diode intracanal laser irradiation on hydrophilic resin-based sealer obturation

Dentin wall structural changes caused by 810-nm-diode laser irradiation can influence the sealing ability of endodontic sealers. The objective of this study was to evaluate the apical leakage of AH Plus and RealSeal resin-based sealers with and without prior diode laser irradiation. Fifty-two single-rooted mandibular premolars were prepared and divided into 4 groups, according to the endodontic sealer used and the use or non-use of laser irradiation. The protocol for laser irradiation was 2.5W, continuous wave in scanning mode, with 4 exposures per tooth. After sample preparation, apical leakage of 50% ammoniacal silver nitrate impregnation was analyzed. When the teeth were not exposed to irradiation, the Real Seal sealer achieved the highest scores, showing the least leakage, with significant differences at the 5% level (Kruskal-Wallis test, p = 0.0004), compared with AH Plus. When the teeth were exposed to the 810-nm-diode laser irradiation, the sealing ability of AH Plus sealer was improved (p = 0282). In the Real Seal groups, the intracanal laser irradiation did not interfere with the leakage index, showing similar results in the GRS and GRSd groups (p = 0.1009).

Dentine microhardness after different methods for detection and removal of carious dentine tissue

There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. Objectives: The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. Material and methods: The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10), according to the method used to identify and remove the carious tissue: "Papacarie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. Results: ANOVA and Tukey's test (alpha=0.05) were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacarie" (424.7 +/- 105.0; a), Caries-detector dye (370.5 +/- 78.3; ab), Tactile method (322.8 +/- 51.5; bc). Results for the remaining dentin microhardness were: "Papacarie" (42.2 +/- 10.5; bc), Caries-detector dye (44.6 +/- 11.8; bc), Tactile method (24.3 +/- 9.0; d). Conclusions: DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacarie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacarie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.

Avaliação qualitativa do efeito de agentes de limpeza na camada de lama dentinária: estudo ultra-estrutural em microscopia eletrônica de varredura

Quando qualquer instrumento abrasiona ou corta a dentina, produz na superfície uma camada de lama dentinária ou smear layer. Dependendo do agente de união indicado em Odontologia adesiva, há a necessidade ou não da remoção da camada de lama da superfície dentinária. Com a finalidade de verificar a ação de diferentes substâncias para a limpeza dentinária, utilizamos 20 dentes pré-molares superiores íntegros, mantidos em soro fisiológico, nos quais as coroas foram seccionadas ao meio no sentido mésio-distal. Com instrumento diamantado, removeu-se o esmalte da porção vestibular e da porção lingual da coroa e, com uma broca carbide cilíndrica lisa nº 56, cortou-se aproximadamente 1 mm de dentina com alta rotação sob abundante refrigeração ar/água, para produzir a camada de lama dentinária. em seguida, essa superfície foi tratada com diferentes substâncias e lavada por 30 segundos com spray ar/água. No controle, foi simplesmente utilizado o spray ar/água. Os espécimes foram montados em suportes metálicos, preparados e visualizados no MEV-DSM 950 da Zeiss, em aumentos que variaram de 100 a 5.000 vezes. Os materiais que mais removeram a camada de lama foram, em ordem crescente: 1. spray ar/água; 2. fluoreto de sódio 2%; 3. associação alternada de Dakin/Tergensol; 4. água oxigenada 3%; 5. jateamento com óxido de alumínio 50 mm; 6. flúor acidulado 1,27%; 7. ácido poliacrílico 25%; 8. ácido fosfórico 10%.

Effect of the surface treatment of plain carbon fiber posts on the retention of the composite core: an in vitro evaluation

Foi avaliado o possível efeito de tratamentos superficiais em pinos de fibra de carbono lisos, quando comparados aos pinos serrilhados, na retenção à resina composta empregada na confecção de núcleos de preenchimento. Foram utilizados cinqüenta pinos de fibra de carbono, divididos em cinco grupos: os quatro primeiros grupos eram constituídos por pinos do tipo liso, cujas superfícies foram tratadas, e o último grupo por dez pinos do tipo serrilhado. Foram desenvolvidas matrizes de resina acrílica com um leito ajustado para conter o pino, com um alargamento na porção coronária para posterior preenchimento com resina composta. Após o tratamento superficial, todos os pinos receberam camadas de primer, foram secos e então ajustados à matriz de resina, colocando-se a resina composta autopolimerizável na porção coronária para um núcleo de preenchimento de 3 mm. As amostras foram submetidas a termociclagem e armazenadas em água destilada por uma semana. Os espécimes foram testados por meio de ensaios mecânicos de tração, à velocidade de 0,5 mm/min, até o deslocamento do conjunto ou a fratura da resina do núcleo. As conclusões foram as seguintes: a) o tratamento superficial nos grupos tratados por meio de jateamento (Grupo A), pontas diamantadas marcadoras de profundidade para facetas laminadas (Grupo C) e alteração da morfologia da extremidade coronária (Grupo D) conferiu aos pinos lisos valores de retenção comparáveis aos dos pinos serrilhados (Grupo E) nos ensaios de tração, porém sem diferença estatisticamente significativa entre estes grupos; b) os pinos tratados por meio de pontas diamantadas de granulação média (Grupo B) obtiveram valores de retenção menores que os demais grupos.

Analysis of Tooth Enamel After Excessive Bleaching: A Study Using Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy

This study assessed alterations on bovine enamel after excessive bleaching. Coronal portions of bovine teeth (n = 30) were sectioned and divided into three groups (n = 10 per group). The coronal parts were further cut incisocervically into two halves. While one half received no bleaching (control), the other half was subjected to either one (group 1), three (group 2), or five bleaching sessions (group 3) with 35% hydrogen peroxide. The enamel surfaces were then analyzed using scanning electron microscopy and energy dispersive x-ray spectroscopy (EDS). Fxcessive bleaching affected the surface morphology and chemistry of the bovine enamel. EDS analysis showed the highest decrease in calcium ion percentages in groups 2 and 3 when compared to their nonbleached halves. Oxygen and phosphorus percentages were comparable on both the control and bleached enamel, regardless of the number of bleaching sessions. Consecutive bleaching sessions with 35% hydrogen peroxide may lead to morphologic and specific elemental changes when performed in a short period of time. Calcium ion percentages may decrease when this bleaching agent is used for more than one session. Int J Prosthodontics 2010;23:29-32.

Pulpal temperature increase with high-speed handpiece, ER : YAG laser and ultrasound tips

The aim of this study was to compare intrapulpal temperature increase produced by high-speed handpiece, Er:YAG laser and CVDentus ultrasound tips during cavity preparation. Thirty bovine mandibular incisors with an enamel/dentin thickness of 4 mm at buccal surface had their roots amputated and were allocated to the following groups (n=10): Group I- high-speed handpiece; Group II- noncontact Er:YAG laser (250 mJ/4Hz); and Group III- CVDentus ultrasouns tips. All devices were used with water cooling. Class V cavities were prepared to a depth of 3.5 mm, measured with a periodontal probe. A type T thermocouple was placed inside the pulp chamber to determine the temperature increase (degrees C), which was recorded by a data acquisition system ADS 2000 IP (Lynx Technology) linked to a notebook computer. Data were analyzed statistically by oneway ANOVA and Tukey's test (p=0.05). The mean temperature rises were: 1.10 degrees C ( 0.56) for Group 1, 0.84 degrees C (0.55) for Group II, and 3.00 degrees C (1.34) for Group III. There were no statistically significant differences (p > 0.05) between Groups I and II, but both of them differed significantly from Group III (p < 0.05). In conclusion, the use of Er:YAG laser and high-speed handpiece for cavity preparation resulted in similar temperature increase. Although ultrasound tips generated significantly higher intrapulpal temperature increase, it remained below the critical value of 5.5 degrees C and may be considered safe for use.

Shear bond strength of a ceramic to Co-Cr alloys

Statement of problem. Different combinations of Co-Cr alloys bonded to ceramic have been used in dentistry; however, the bond strength of ceramic to metal can vary because of different compositions of these alloys.Purpose. The purpose of this study was to evaluate the shear bond strength of a dental ceramic to 5 commercially available Co-Cr alloys.Material and methods. Five Co-Cr alloys (IPS d.SIGN 20, IPS d.SIGN 30, Remanium 2000, Heranium P, and Wirobond C) were tested and compared to a control group of an Au-Pd alloy (Olympia). Specimen disks, 5 mm high and 4 mm in diameter, were fabricated with the lost-wax technique. Sixty specimens were prepared using opaque and dentin ceramics (VITA Omega 900), veneered, 4 mm high and 4 mm in diameter, over the metal specimens (n = 10). The shear bond strength test was performed in a universal testing machine with a crosshead speed of 0.5 mm/min. After shear bond testing, fracture surfaces were evaluated in a stereomicroscope under x25 magnification. Ultimate shear bond strength (MPa) data were analyzed with 1-way ANOVA and the Tukey HSD test (alpha = .05).Results. The mean (SID) bond strengths (MPa) were: 61.4 (7.8) for Olympia; 94.0 (18.9) for IPS 20; 96.8 (10.2) for I PS 30; 75.1 (12.4) for Remanium; 71.2 (14.3) for Heranium P; and 63.2 (10.9) for Wirobond C. Mean bond strengths for IPS 20 and IPS 30 were not significantly different, but were significantly (P<.001) higher than mean bond strengths for the other 4 alloys, which were not significantly different from each other.Conclusions. Bond strength of a dental ceramic to a Co-Cr alloy is dependent on the alloy composition.

Effect of Static and Cyclic Loading on Ceramic Laminate Veneers Adhered to Teeth with and Without Aged Composite Restorations

Purpose: Existing composite restorations on teeth are often remade prior to the cementation of fixed dental prostheses. The aim of this study was to evaluate the effect of static and cyclic loading on ceramic laminate veneers adhered to aged resin composite restorations.Materials and Methods: Eighty sound maxillary incisors were collected and randomly divided into four groups: group 1: control group, no restorations; group 2: two Class III restorations; group 3: two Class IV restorations; group 4: complete composite substrate. Standard composite restorations were made using a microhybrid resin composite (Anterior Shine). Restored teeth were subjected to thermocycling (6000 cycles). Window preparations were made on the labial surface of the teeth for ceramic laminate fabrication (Empress II). Teeth were conditioned using an etch-and-rinse system. Existing composite restorations representing the aged composites were silica coated (CoJet) and silanized (ESPE-Sil). Ceramic laminates were cemented using a bis-GMA-based cement (Variolink Veneer). The specimens were randomly divided into two groups and were subjected to either static (groups 1a, 2a, 3a, 4a) or cyclic loading (groups 1b, 2b, 3b, 4b). Failure type and location after loading were classified. Data were analyzed using one-way ANOVA and Tukey's test.Results: Significantly higher fracture strength was obtained in group 4 (330 +/- 81 N) compared to the controls in group 1 (179 +/- 120 N) (one-way ANOVA, p < 0.05). Group lb survived a lower mean number of cyclic loads (672,820 cycles) than teeth of groups 2b to 4b (846x10(3) to 873x10(3) cycles). Failure type evaluation after the fracture test showed predominantly adhesive failures between dentin and cement, but after cyclic loading, more cohesive fractures in the ceramic were seen.Conclusion: Ceramic laminate veneers bonded to conditioned aged composite restorations provided favorable results. Surface conditioning of existing restorations may eliminate the necessity of removing aged composite restorations.

Effect of Acid Neutralization and Mechanical Cycling on the Microtensile Bond Strength of Glass-ceramic Inlays

Objectives: To evaluate the hypothesis that a process of hydrofluoric acid precipitate neutralization and fatigue load cycling performed on human premolars restored with ceramic inlays had an influence on microtensile bond strength results (MTBS). Methods: MOD inlay preparations were performed in 40 premolars (with their roots embedded in acrylic resin). Forty ceramic restorations were prepared using glass-ceramic (IPS Empress). The inner surfaces of all the restorations were etched with 10% hydrofluoric acid for 60 seconds, rinsed with water and dried. The specimens were divided into two groups (N=20): 1-without neutralization; 2-with neutralization. All the restorations were silanized and adhesively cemented (self-curing and self-etching luting composite system, Multilink). Ten premolars from each group were submitted to mechanical cycling (1,400,000 cycles, 50N, 37 degrees C). After cycling, the samples were sectioned to produce non-trimmed beam specimens (vestibular dentin-restoration-lingual dentin set), which were submitted to microtensile testing. Results: Bond strength was significantly affected by the surface treatment (p<0.0001) (no neutralization > neutralization) and mechanical cycling (p<0.0001) (control > cycling) (2-way ANOVA and Tukey test, alpha=.05). Conclusion: Hydrofluoric acid precipitate neutralization appears to significantly damage the resin bond to glass-ceramic and should not be recommended. The clinical simulation of the specimens, by using mechanical cycling, is important when evaluating the ceramic-dentin bond.

Effect of Carbamide Peroxide Bleaching Gel Concentration on the Bond Strength of Dental Substrates and Resin Composite

Purpose: This study evaluated the effect of bleaching gel containing 10%, 15% and 20% carbamide peroxide (CP) on the bond strength of dental enamel or dentin and resin composite restorations.Methods: The buccal surfaces of 12 bovine tooth crowns were conditioned with 37% phosphoric acid, and the adhesive resin Single Bond 2 and the resin composite Filtek Z350 were used to perform the restorations. The blocks were sectioned to obtain bar specimens. Each specimen group (enamel-E, dentin-D) was divided into four subgroups (n=15): S-artificial saliva; 10-10% CP bleaching; 15-15% CP bleaching; 20-20% CP bleaching. CP was applied for six hours daily for two weeks. The specimens were submitted to the a test in a universal testing machine. The data were analyzed by one-way ANOVA and the Tukey post-hoc test and a correlation analysis (r) was performed.Results: For Group E, the mean value (+/- standard-deviation) was 21.86 (+/- 6.03)a, 18.91 (+/- 8.31)ab, 15.43 (+/- 7.44)b and 10.6 (+/- 4.94)c for ES, E10, E15 and E20, respectively. For Group D, the alpha values were 34.73 (+/- 4.68)a, 35.12 (+/- 13.43)a, 29.67 (+/- 6.84)ab and 24.56 (+/- 6.54)b for DS, D10, D15 and D20, respectively. A negative correlation between the CP concentration and mean values was observed for both the enamel (r=-0.95) and dentin (r=-0.85) groups.Conclusion: In the current study, the bond strength of the restoration to enamel and the restoration to dentin were influenced by the application of CP and was dependent on the CP concentration in the bleaching gel.

The adhesive system and root canal region do not influence the degree of conversion of dual resin cement

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

Effects of cement thickness and bonding on the failure loads of CAD/CAM ceramic crowns: Multi-physics FEA modeling and monotonic testing

Objective. To determine the influence of cement thickness and ceramic/cement bonding on stresses and failure of CAD/CAM crowns, using both multi-physics finite element analysis and monotonic testing.Methods. Axially symmetric FEA models were created for stress analysis of a stylized monolithic crown having resin cement thicknesses from 50 to 500 mu m under occlusal loading. Ceramic-cement interface was modeled as bonded or not-bonded (cement-dentin as bonded). Cement polymerization shrinkage was simulated as a thermal contraction. Loads necessary to reach stresses for radial cracking from the intaglio surface were calculated by FEA. Experimentally, feldspathic CAD/CAM crowns based on the FEA model were machined having different occlusal cementation spaces, etched and cemented to dentin analogs. Non-bonding of etched ceramic was achieved using a thin layer of poly(dimethylsiloxane). Crowns were loaded to failure at 5 N/s, with radial cracks detected acoustically.Results. Failure loads depended on the bonding condition and the cement thickness for both FEA and physical testing. Average fracture loads for bonded crowns were: 673.5 N at 50 mu m cement and 300.6 N at 500 mu m. FEA stresses due to polymerization shrinkage increased with the cement thickness overwhelming the protective effect of bonding, as was also seen experimentally. At 50 mu m cement thickness, bonded crowns withstood at least twice the load before failure than non-bonded crowns.Significance. Occlusal "fit" can have structural implications for CAD/CAM crowns; pre-cementation spaces around 50-100 mu m being recommended from this study. Bonding benefits were lost at thickness approaching 450-500 mu m due to polymerization shrinkage stresses. (C) 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Bond strengths, degree of conversion of the cement and molecular structure of the adhesive-dentine joint in fibre post restorations

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Marginal leakage in Class V cavities pretreated with different laser energy densities

The purpose of the present study was to evaluate in vitro the degree of marginal leakage in Class V cavities involving the cementoenamel junction. Cavities were 4 rum wide and 2 mm deep. The specimens received dentin pretreatment (37% phosphoric acid) followed by the Single Bond (3M) adhesive system application. The 40 specimens were then divided into four groups: Group I (control); Group 2 (Nd:YAG laser at 120 mJ/pulse, frequency of 10 Hz, power of 1.2 W); Group 3 (Nd:YAG laser at 140 mJ/pulse, frequency of 10 Hz, power of 1.4 W); Group 4 (Nd:YAG laser at 160 mJ/pulse, frequency of 10 Hz, power of 1.6 W). The cavities were restored with Z100 composite resin (3M) and light cured at 300-600 mW/cm(2) light intensity. Specimens were thermocycled to 500 cycles from 2-50 degrees C. After that, they were dried and sealed with nail varnish, respecting 1 mm around the restorations, and immersed in 0.5% methylene blue solution for 4 h. After this period, the teeth were rinsed, dried, sectioned, and analyzed in a stereoscopic loupe. The highest leakage scores were considered for each specimen. The results were statistically analyzed by the analysis of variance (ANOVA) Kruskal-Wallis test to the 5% level. For both the enamel and cementum, there was a decrease in marginal leakage with the application of laser energy; no significant differences were observed for Groups 2, 3, and 4. The results also showed a smaller tendency to marginal leakage on the cementum than on the enamel.