Effect of thermocycling on internal microhardness of high and low viscosity bulk fill composite resins in class I cavities / Efeito da termociclagem na microdureza interna de resinas compostas bulk fill de alta e baixa viscosidade aplicadas em cavidades classe I

ABSTRACT Objective: To evaluate the effect of thermocycling on the Knoop internal microhardness of high- and low viscosity bulk fill resins applied in Class I cavities. Methods: Thirty third molars with Class I cavity preparations were randomly divided into 3 groups according to the restorative system: nanoparticulated composite resin (Filtek™ Z350 XT 3M ESPE) (oblique increments of 2mm); low viscosity bulk fill resin (Filtek™ Bulk fill Flow, 3M ESPE) (3mm increments covered with a 1-mm layer of nanoparticulated resin); high viscosity bulk fill resin (Filtek™ Bulk fill, 3M ESPE) (single 4-mm increment). After 24h, half of samples was submitted to thermocycling (1,000 cycles). All samples (n=5) were sectioned in half to measure the internal microhardness at bottom and top of restoration. Results: Analysis of variance indicated that, for nanoparticulated composite resin, without thermocycling, the microhardness at the top was statistically lower than at the bottom. After thermocycling, there was no difference in microhardness between the top and the bottom. For low viscosity bulk fill resin, without thermocycling, there was no significant difference in microhardness means between the top and the bottom. After thermocycling, significantly higher microhardness was found at the top than at the bottom (p <0.05). For high viscosity bulk fill resin there was no significant difference between the microhardness values at the top and bottom, regardless of thermocycling (p> 0.05). In all composite resins, an increase in microhardness was observed after thermocycling (p <0.05). Conclusion: Thermocycling increased the internal microhardness of resin restorations, and, for the low viscosity bulk fill resin, the microhardness at the top was higher than at the bottom after thermocycling.

RESUMO Objetivo: Avaliar o efeito da termociclagem na microdureza Knoop interna de resinas bulk fill de alta e baixa viscosidade aplicadas em cavidades classe I. Métodos: Trinta terceiros molares com cavidades Classe I foram divididos aleatoriamente em três grupos de acordo com o sistema restaurador: Resina composta nanoparticulada (Filtek™ Z350 XT 3M ESPE) (incrementos oblíquos de 2mm); resina bulk fill de baixa viscosidade (Filtek™ Bulk fill Flow, 3M ESPE) (incremento de 3mm mais 1mm de resina nanoparticulada); resina bulk fill de alta viscosidade (Filtek ™ Bulk fill, 3M ESPE) (único incremento de 4mm). Após 24h, metade das amostras foi submetida a termociclagem (1.000 ciclos). Todas as amostras (n=5) foram seccionadas ao meio para mensuração da microdureza interna na base e topo da restauração. Resultados: Análise de variância indicou que, para a resina composta nanoparticulada e antes da termociclagem, a microdureza no topo foi estatisticamente inferior do que na base (p<0,05). Após a termociclagem, não houve diferença entre topo e base. Já para a resina bulk fill de baixa viscosidade, antes da termociclagem, não se constatou diferença significativa nos valores de microdureza entre topo e base. Após termociclagem, valores significativamente mais elevados de microdureza foram encontrados no topo do que na base (p<0,05). Para resina bulk fill de alta viscosidade, não houve diferença significativa na microdureza entre topo e base, realizando-se ou não termociclagem (p>0,05). Em todas as resinas compostas foi verificado aumento de microdureza após termociclagem (p<0,05). Conclusão: A termociclagem aumentou a microdureza para todas as resinas compostas, sendo que para a resina bulk fill de baixa viscosidade a microdureza no topo foi maior do que na base após termociclagem.

Dentin permeability after pretreatment with titanium tetrafluoride and self-etching or universal adhesive systems

Aim: To evaluate dentin permeability after pretreatment with 2.5% aqueous solution of titanium tetrafluoride (TiF4), followed by a self-etching universal adhesive system. Methods: Forty dentin discs (1.5 mm thick) were randomly divided into groups according to the application or non-application of a pretreatment, and the type of adhesive system to be tested (two-step self-etching/ Clearfil SE Bond/ Kuraray Medical, or universal adhesive system/ Single Bond Universal/ 3M ESPE). Both sides of the discs were conditioned with 37% phosphoric acid to remove the smear layer. The first hydraulic conductivity measurement (L1) was performed in a permeability machine, under 5 PSI pressure. The samples were sanded again to form a standardized smear layer. The teeth designated for pre-treatment with TiF4 received the TiF4 solutions applied actively for 60 seconds, and the adhesive systems were applied according to the manufacturer's instructions. Then, a new hydraulic conductivity measurement (L2) was performed for the purpose of calculating the hydraulic conductance at a later time, considering the water viscosity and the thickness of the specimen. The percentage (L) of dentin permeability after application of the adhesive system was obtained (L (%) = [(L1-L2) x100] / L1). The Mann-Whitney non-parametric test was applied. Results: There was no difference between the two adhesive systems, or between the groups with or without pretreatment, as regards dentin permeability (p>0.05). Conclusion: Pretreatment with 2.5% TiF4 did not influence dentin permeability, irrespective of the adhesive system used

Diagnostic methods for stained pits and fissures caries lesions on the occlusal surface / Métodos diagnósticos para lesões de cárie com sulcos pigmentados em superfície oclusal

ABSTRACT Objective: The aim of this study was to compare methods for in vitro diagnosis of pigmented pits and fissures on the occlusal surface. Methods: Forty-one human molars and premolars extracted with pigmentation in pits and fissures were used. The teeth were evaluated with artificial illumination for classification according to ICDAS, followed by fluorescent laser evaluation. For the radiographic evaluation, the teeth were positioned to obtain interproximal images, adopting the criterion of Rodrigues et al. 2008 for diagnosis of lesions. For histological evaluation, the teeth were sectioned in the mesiodistal direction in the occlusal sulcus region and evaluated in a 20-fold stereoscopic magnifying glass, using the criterion of Ekstrand et al. (1997) for evaluation. The methods were compared with the histological evaluation, obtaining values of accuracy, sensitivity and specificity regarding the response variables "presence / absence" of enamel caries. Results: When comparing visual inspection with histological analysis, 65.85% accuracy, 40% sensitivity and 90.48% specificity were observed with false positive and negative probability of 20% and 38.71%. When comparing the fluorescent laser with the histological analysis, the accuracy was 58.54%, sensitivity 70% and specificity 47.62%. Comparing the radiographic analysis with the histological analysis, it was obtained 53.66% accuracy, sensitivity of 42.11% and specificity of 73.68%. Conclusion: The ROC curve and the Yuden index showed that visual inspection presented the best combination of sensitivity and specificity than fluorescent laser and radiographic analysis for diagnosis, which represented the best method for detecting inactive carious lesions in enamel.

RESUMO Objetivo: O objetivo deste estudo foi comparar métodos para diagnóstico in vitro de sulcos pigmentados em superfície oclusal. Métodos: Foram utilizados 41 molares e pré-molares humanos extraídos com pigmentação em sulcos e fissuras. Os dentes foram avaliados com iluminação artificial para classificação quanto ao critério ICDAS, seguida por avaliação com laser fluorescente. Para a avaliação radiográfica, os dentes foram posicionados para obtenção de imagens interproximais, adotando-se o critério de Rodrigues et al. (2008) para diagnóstico. Para avaliação histológica, os dentes foram seccionados no sentido mésio-distal na região de sulco oclusal e avaliados em lupa estereoscópica com aumento de 20 vezes, adotando-se o critério de Ekstrand et al. (1997). Os métodos foram comparados com a avaliação histológica, obtendo-se valores de acurácia, sensibilidade e especificidade quanto às variáveis de resposta "presença/ausência" de lesão de cárie em esmalte. Resultados: Ao comparar a inspeção visual com a análise histológica, observou-se acurácia de 65,85%, sensibilidade de 40% e especificidade de 90,48%. Ao comparar o laser fluorescente com a análise histológica, a acurácia foi de 58,54%, sensibilidade de 70% e especificidade de 47,62%. Na comparação da análise radiográfica com a histológica, obteve-se acurácia de 53,66%, sensibilidade de 42,11% e especificidade de 73,68%. Conclusão: A curva ROC mostrou que a inspeção visual apresentou a melhor combinação de sensibilidade e especificidade que o laser fluorescente e que a análise radiográfica para o diagnóstico, representando o melhor método para detecção de cárie em lesões com sulcos pigmentados em esmalte

Remineralizing effect of commercial fluoride varnishes on artificial enamel lesions

Abstract: The aim of this study was to evaluate soluble and insoluble fluoride concentrations in commercial varnishes, and their remineralization effect on artificial caries enamel lesions using surface and cross-sectional microhardness evaluations. Forty bovine enamel blocks were separated into four groups (n=10): control (no treatment), Enamelast (Ultradent Products), Duraphat (Colgate-Palmolive) and Clinpro White Varnish (3M ESPE). Surface enamel microhardness evaluations were obtained, artificial enamel caries lesions were developed by dynamic pH-cycling, and the varnishes were then applied every 6 days, after which the enamel blocks were submitted to dynamic remineralization by pH cycles. After removal of the varnishes, the enamel surfaces were reassessed for microhardness. The blocks were sectioned longitudinally, and cross-sectional microhardness measurements were performed at different surface depths (up to 300 μm depth). Polarized light microscopy images (PLMI) were made to analyze subsurface caries lesions. The fluoride concentration in whole (soluble and insoluble fluoride) and centrifuged (soluble fluoride) varnishes was determined using an extraction method with acetone. The data were analyzed to evaluate the surface microhardness, making adjustments for generalized linear models. There was a significant decrease in enamel surface microhardness after performing all the treatments (p<0.0001). Enamelast and Duraphat showed significantly higher enamel microhardness values than the control and the Clinpro groups (p = 0.0002). Microhardness loss percentage was significantly lower for Enamelast (p = 0.071; One-way ANOVA). PLMI showed that subsurface caries lesions were not remineralized with the varnish treatments. No significant differences in the in-depth microhardness levels (p = 0.7536; ANOVA) were observed among the treatments. Enamelast presented higher soluble and insoluble fluoride concentrations than the other varnishes (p < 0.0001; Kruskal-Wallis and Dunn tests). Enamelast and Duraphat varnishes promoted enamel surface remineralization, but no varnish remineralized the subsurface lesion body. Although insoluble and soluble fluoride concentration values did not correspond to those declared by the manufacturer, Enamelast presented higher fluoride concentration than the others.