Influence of light intensity and curing cycle on microleakage of Class V composite resin restorations

O objetivo deste estudo foi determinar o efeito da polimerização gradual, mediante a utilização de aparelhos de Quartzo-Tungustênio-Halógena (QTH) e Arco de Plasma de Xenônio (PAC), no selamento marginal de restaurações classe V em resina composta com margens localizadas em dentina. Setenta e cinco incisivos bovinos receberam preparos de cavidades classe V, na raiz, com o intuito de situar as margens cavitárias em dentina. Os dentes foram divididos em cinco grupos de acordo com o método de fotoativação. As cavidades, depois de condicionadas, foram tratadas com o sistema adesivo Single Bond (3M Dental) e restauradas com a resina composta Z100 (3M Dental) pela técnica incremental. A fotoativação foi realizada para cada grupo como descrito a seguir: Grupo I: PAC pelo método de fotoativação constante: 1600mW/cm² – 3s; Grupo II: PAC pelo método de fotoativação por passos (800mW/cm² – 2s, subindo automaticamente para 1600mW/cm² – 4s); Grupo III: QTH pelo método de fotoativação constante: 400 mW/cm² – 40s; Grupo IV: QTH pelo método de fotoativação em rampa: 100 a 600 mW/cm² – 15s, permanecendo a 600mW/cm² por mais 25s; Grupo V: QTH pelo método de fotoativação por pulso: 200 mW/cm² – 3s, tempo de espera de 3min.e a seguir 600mW/cm² – 30s. Os dentes foram armazenados em água destilada a 37ºC por 30 dias e então submetidos à ciclagem térmica, por 500 ciclos à 5 ºC e 55 ºC. Os ápices dos dentes foram selados com resina composta e os dentes foram cobertos com duas camadas de esmalte para unha, antes da sua imersão em fucsina básica a 0,5%. Os dentes foram seccionados e os cortes foram escaneados para avaliação da área infiltrada por corante por um programa de computador (Image Tools). Os cortes foram também visualizados com lupa para a determinação do grau de penetração do corante na interface dente-restauração por escores. Diferenças estatisticamente significantes foram observadas entre os grupos quanto ao grau e à área de penetração de corante (p < 0,05). Os grupos I e II apresentaram valores significantemente mais altos de infiltração e penetração do corante que os grupos III, IV e V. Em conclusão, o uso da fonte de PAC, no modo constante e por passos, resultou em valores significantemente maiores de infiltração marginal quando comparados com a intensidade de luz média emitida pelos aparelhos de QTH. Os métodos de fotoativação por pulso, rampa e continuo com a fonte de QTH resultaram num grau similar de microinfiltração.

Effect of different adhesive systems on microleakage in class II composite resin restorations

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

Marginal adaptation of Class 2 adhesive restorations

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups ( n = 20): ( 1) oblique incremental insertion technique ( control), ( 2) centripetal incremental insertion technique, and ( 3) bulk insertion. The teeth were restored with a total-etch adhesive and micro-hybrid composite resin. The specimens were isolated with nail varnish except for a 2-mm-wide area around the restoration and then thermocycled ( 1,000 thermal cycles, 5 degrees C/ 55 degrees C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores ( 0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests ( P <.05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores ( P =.15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins ( P =.04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques.

Indicators of the risk mechanics for Class-I and Class-II amalgam and composite resin restorations

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

Use of the connective tissue graft for the coverage of composite resin-restored root surfaces in maxillary central incisors

The purpose of this article is to report the use of the subepithelial connective tissue graft technique combined with the coronally positioned flap on a composite resin-restored root surface to treat Miller Class I gingival recessions associated with deep cervical abrasions in maxillary central incisors. Clinical measurements, including gingival recession height, probing depth, and bleeding on probing (BoP), were recorded during the preoperative clinical examination and at 2, 6, 12, and 24 months postoperatively. During the follow-up periods, no periodontal pockets or BoP were observed. The periodontal tissue of the teeth presented normal color, texture, and contouring. In addition, it was observed that creeping attachment had occurred on the restoration. This case report shows that this form of treatment can be highly effective and predictable in resolving gingival recession associated with a deep cervical abrasion. (Quintessence Int 2012;43:597-602)

Effect of the Insertion and Polymerization Technique in Composite Resin Restorations: Analysis of Marginal Gap by Atomic Force Microscopy

This in vitro study evaluated the marginal gap at the composite tooth/resin interface in class V cavities under the influence of two insertion techniques and a curing system by means of atomic force microscopy (AFM). Forty enamel and dentin cavities were prepared on the buccal surface in bovine teeth with quadratic forms measuring 2 mm X 2 mm and depth of 1.5 mm. The teeth were then divided into four groups: group A, 10 cavities were restored in one increment, light cured by halogen light; group B, 10 cavities filled with bulk filling, light cured by the light emitting diodes (LED); group C, 10 cavities were restored by the incremental technique, light cured by halogen light; group D, 10 cavities were restored by the incremental technique, light cured by the LED. The teeth underwent the polishing procedure and were analyzed by AFM for tooth/restoration interface evaluation. The data were compared between groups using the nonparametric Kruskall-Wallis and Mann-Whitney tests (p < 0.05). The results showed a statistically significant difference between groups A and B and groups A and C. It was concluded that no insertion and polymerization technique was able to completely seal the cavity.

A thirty months clinical evaluation of a posterior composite resin in primary molars

The purpose of this in vivo study was to evaluate the clinical performance of a posterior composite resin TRH (Caulk Dentisply) in class I restorations in primary molars. A total of 30 children aged 5 to 8 years old with 49 class I dental lesions in primary molars participated in the study. The cavity preparations involved removal of carious lesion only and the enamel margins were beveled. The results showed after 30 months that, 82% (32/39) of Alfa ratings and 18% (7/39) of Bravo ratings. We concluded that the composite resin TP-H could be used in conservative restorations in primary molars, particularly in the late mixed dentition.

Scanning electron microscope analysis of internal adaptation of materials used for pulp protection under composite resin restorations

Purpose: The aim of this study was to evaluate the interfacial microgap with different materials used for pulp protection. The null hypothesis tested was that the combination of calcium hydroxide, resin-modified glass ionomer, and dentin adhesive used as pulp protection in composite restorations would not result in a greater axial gap than that obtained with hybridization only. Materials and Methods: Standardized Class V preparations were performed in buccal and lingual surfaces of 60 caries-free, extracted human third molars. The prepared teeth were randomly assessed in six groups: (1) Single Bond (SB) (3M ESPE, St. Paul, MN, USA); (2) Life (LF) (Kerr Co., Romulus, MI, USA) + SB; (3) LF + Vitrebond (VT) (3M ESPE) + SB; (4) VT + SB; (5) SB + VT; (6) SB + VT + SB. They were restored with microhybrid composite resin Filtek Z250 (3M ESPE), according to the manufacturer's instructions. However, to groups 5 and 6, the dentin bonding adhesive was applied prior to the resin-modified glass ionomer. The specimens were then thermocycled, cross-sectioned through the center of the restoration, fixed, and processed for scanning electron microscopy. The specimens were mounted on stubs and sputter coated. The internal adaptation of the materials to the axial wall was analyzed under SEM with × 1,000 magnification. Results: The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, p ≤ .05). The null hypothesis was rejected. Calcium hydroxide and resin-modified glass ionomer applied alone or in conjunction with each other (p < .001) resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration. ©2005 BC Decker Inc.

Influence of surface sealants on microleakage of composite resin restorations

Purpose: The purpose of this study was to verify the influence of surface sealants and dentin adhesive systems on the microleakage of composite restorations. Methods: Class V cavities were made on the buccal faces of 100 permanent third molars and restored with Z250. After 24 hours, they were submitted to polishing and finishing processes. The teeth were divided into groups according to the sealant agent: group 1 - Single Bond; group 2 - Opti Bond Solo Plus; group 3 - Fortify; group 4 - Fortify Plus; and group 5 - control without sealant. The analysis of immediate microleakage was performed in 10 restorations from each group, soon after the sealing. The other 10 specimens from each group were submitted to tooth-brushing and thermal cycles. The teeth were isolated and immersed in 2% methylene blue solution, washed in tap water, and sectioned in the buccolingual direction. The percentage of marginal leakage was calculated using an image analysis program, and results were submitted to analysis of variance and Tukey's test. Results: All the sealed groups demonstrated lower microleakage values compared to the control group. Group 3, sealed with Fortify, presented the lowest mean microleakage values. Conclusion: The application of surface sealants effectively decreased the microleakage in composite resin restorations.

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)