ABSTRACT
Abstract: Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.
Subject(s)
Humans , Dental Caries/therapy , Dental Restoration, Permanent , Prospective Studies , Follow-Up Studies , Dental Marginal Adaptation , Composite Resins , Resin Cements , Glass Ionomer Cements/therapeutic useABSTRACT
Objetivo: O objetivo desse estudo foi investigar a permeabilidade dentinária e a oclusão tubular de materiais dessensibilizantes de uso em consultório. Métodos: Blocos de dentina bovina foram obtidos e imersos em EDTA 0,5 M para promover a abertura dos túbulos dentinários. Os materiais testados foram: verniz placebo (PLA); verniz fluoretado (FLU); verniz de NaF 5% + 5% trimetafosfato de sódio nanoparticulado (TMP); sistema adesivo universal (SBU); verniz contendo partículas S-PRG (SPRG); solução de Biosilicato (BIOS) e solução de amelotina (AMTN). Os materiais foram aplicados e os espécimes submetidos ao desafio erosivo-abrasivo. A permeabilidade dentinária foi avaliada em T0 (inicial), T1 (após a aplicação dos materiais) e T2 (após o desafio erosivo-abrasivo). As imagens confocais foram usadas para avaliar o comprimento e o número dos túbulos ocluídos e as imagens de microscopia eletrônica de varredura (MEV) para avaliar o número de tubulos abertos. Os dados de permeabilidade e MEV foram analisadas pelo teste ANOVA duas medidas repetidas e pós teste de Tukey. O comprimento e número de túbulos dentinários ocluídos foram analisadas pelo teste ANOVA um critério e pós teste de Tukey, Kruskal-Wallis e pós teste de Dunn's, respectivamente. Os testes de correlação de Spearman e Pearson também foram realizados. O nível de significância foi de 5%. Resultados: O grupo AMTN mostrou os menores valores de permeabilidade em T1 e a seguinte ordem decrescente ocorreu em T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. O grupo SBU teve o maior comprimento médio de túbulos dentinários ocluídos. O grupo AMTN teve maior número de túbulos dentinários ocluídos do que PLA e FLU e os menores valores de túbulos dentinários abertos foram observados para os grupos AMTN e SBU. Uma correlação significativa foi encontrada entre as análises realizadas. Significância: O sistema adesivo universal e a proteína amelotina foram mais efetivos em reduzir a permeabilidade dentinária através da oclusão dos túbulos dentinários(AU)
Objectives: The aim of this study was to investigate the dentin permeability and tubule occlusion of in-office desensitizing materials. Methods: Bovine dentin blocks were obtained and immersed in 0.5 M EDTA to open dentinal tubules. The materials tested were: placebo varnish (PLA); fluoride varnish (FLU); NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP); universal adhesive system (SBU); S-PRG filler-containing varnish (SPRG); Biosilicate solution (BIOS) and amelotin solution (AMTN). The materials were applied, and specimens were submitted to an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after application of materials) and T2 (after erosive-abrasive challenge). Confocal images were used to evaluate length and number of dentinal tubules occluded and images from scanning electron microscopy (SEM) to evaluate opened dentinal tubules. Permeability and SEM data were evaluated by two-way repeated measures ANOVA and Tukey tests. The length and number of dentinal tubules occluded were evaluated by one-way ANOVA and Tukey, Kruskal-Wallis and Dunn's tests, respectively. Spearman and Pearson correlation tests were also used. The significance level was 5%. Results: AMTN group showed the lowest permeability value in T1 and the following decreasing order occurred in T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. SBU group had the highest mean value of dentinal tubules occluded lengths. AMTN group had greater number of dentinal tubules occluded than PLA and FLU and the lowest values of opened dentin tubules were observed for AMTN and SBU groups. A significant negative correlation was found between the analysis. Significance: Universal adhesive system and the AMTN solution were more effective to reduce dentin permeability by occluding dentin tubules(AU)