Is the Er:YAG laser affect the surface characteristics and bond strength of Y-TZP?

Abstract This study evaluated the surface characteristics and bond strength of Y-TZP treated with Er:YAG laser at different focal distances. 120 Y-TZP blocks were divided into five groups (n=24), according to the surface treatment: no treatment (C-); sandblasting with silica-coated aluminum oxide particles (C+); and Er:YAG laser application at focal distances of 1mm (Er:YAG-1), 4mm (Er:YAG-4), and 7mm (Er:YAG-7). Surface characteristics were analyzed using Vickers microhardness, confocal laser microscope, scanning electron microscopy (SEM), and X-ray diffractometer (XRD). For the bond strength test, 100 Y-TZP blocks were subdivided into two subgroups (n=10), according to the resin cement used: with (MDP+) or without 10-methacryloyloxydecyl dihydrogen phosphate (MDP-). The Vickers microhardness and surface roughness were analyzed by one-way ANOVA and bond strength by two-way ANOVA and Tukey's test for both (α=0.05). Vickers microhardness differences were not observed between the groups (p>0.05); C+ showed higher surface roughness values. SEM images showed micromorphological differences between the groups. The XRD data detected tetragonal crystals for C- and, for the other groups, tetragonal and monoclinic peaks. For bond strength, no statistically difference significance were observed among the cements with or without MDP (p>0.05) but showed significant difference between the surface treatments (C+ > C- = Er:YAG1 > Er:YAG4 = Er:YAG7) (p<0.05). Suggested that the Er:YAG laser cannot replace conventional treatment with aluminum oxide particles and the presence of MDP in the resin cement had no influence on the bond strength.

Resumo Este estudo avaliou as características de superfície e resistência de união de Y-TZP tratado com laser de Er: YAG em diferentes distâncias focais. Cento e vinte blocos de Y-TZP foram divididos em cinco grupos (n=24), de acordo com a superfície de tratamento: sem tratamento (C-); asperização com partículas de óxido de alumínio revestidas por sílica (C +); e aplicação de laser Er: YAG a distâncias focais de 1 mm (Er: YAG-1), 4 mm (Er: YAG-4) e 7 mm (Er: YAG-7). As características de superfície foram analisadas por meio de microdureza Vickers, microscópio confocal a laser, microscopia eletrônica de varredura (MEV) e difratômetro de raios-X (DRX). Para o ensaio de resistência de união, cem blocos de Y-TZP foram subdivididos em 2 subgrupos (n=10) de acordo com o cimento resinoso utilizado (n=12): com 10-metacriloiloxidecil dihidrogenofosfato (MDP+) ou sem (MDP-). Microdureza Vickers e rugosidade de superfície foram analisadas por ANOVA a 1 fator e a resistência de união por ANOVA a 2 fatores e ambos seguidos de teste complementar de Tukey (α=0,05). Não foram observadas diferenças de microdureza Vickers entre os grupos; C+ apresentou maiores valores de rugosidade superficial. Imagens de MEV mostraram diferenças micromorfológicas entre os grupos. Os dados de DRX detectaram apenas cristais tetragonais para C- e, para os outros grupos, picos de zircônia nas fases tetragonal e monoclínica. Para a resistência de união, não foram observadas diferenças estatisticamente significante entre os cimentos com e sem MDP (p>0.05), mas foram observadas diferenças significativas entre os tratamentos de superfície (C+ > C- = Er:YAG1 > Er:YAG4 = Er:YAG7) (p<0.05). Sugere-se que o laser de Er: YAG não pode substituir o tratamento convencional com partículas de óxido de alumínio e a presença de MDP no cimento resinoso não influenciou na resistência de união.

Chlorhexidine and proanthocyanidin enhance the long-term bond strength of resin-based endodontic sealer

Abstract The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.

Non-contact profilometry of eroded and abraded enamel irradiated with an Er: YAG laser

Abstract Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (μm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion.

Fracture Strength of Weakened Anterior Teeth Associated to Different Reconstructive Techniques

Abstract This study evaluated the fracture strength of endodontically treated teeth submitted to reconstructive techniques through dynamic and static tests. Forty human anterior teeth were divided into 4 groups (n=10): GNW (non-weakened) - root restored with glass fiber post (GFP), GW - weakened root restored with GFP, GDA - weakened root restored with direct anatomic GFP, and GIA - weakened root restored with indirect anatomic GFP. The teeth were endodontically treated considering that experimental groups (GW, GDA and GIA) simulated weakened roots for restoration with GFP using different techniques. The GFP was luted with resin cement and the coronal portion was restored with composite resin and metallic crowns. All samples were submitted to chewing simulation at 60 cycles/min in a total of 300,000 cycles. The survival samples were further exposed to compressive loading at a crosshead speed of 1.0 mm/min in a universal testing machine. The load was applied at 135° to the long axis of the tooth until failure. Data were analyzed by ANOVA (a=0.05). After chewing simulation were observed: GNW: 100% of survival roots; GW: 70% of survival roots, and GDA and GIA: 80% of survival roots. The mean fracture strength values (N) were 280.6 (GNW), 239.0 (GW), 221.3 (GDA), and 234.1 (GIA) without significant difference among the groups (p=0.7476). The results suggested similar fracture strength in both weakened and non-weakened teeth regardless the reconstructive technique of root internal wall. Higher incidence of catastrophic fracture was observed in weakened teeth without restoration of the root internal wall.

Resumo Este estudo avaliou a resistência à fratura de dentes tratados endodonticamente submetidos a diferentes técnicas de reconstrução por meio de testes dinâmico e estático. Quarenta dentes humanos anteriores foram divididos em 4 grupos (n=10): GNW (não fragilizado): raiz restaurada com pino de fibra de vidro (PFV), GW: raiz fragilizada restaurada com PFV, GDA: raiz fragilizada restaurada com PFV anatômico direto, e GIA: raiz fragilizada restaurada com PFV anatômico indireto. Os dentes foram tratados endodonticamente considerando que nos grupos experimentais (GW, GDA e GIA) simulou-se fragilização radicular das raízes para restauração com PFV utilizando diferentes técnicas. Os PFV foi cimentados com cimento resinoso e a porção coronária foi restaurada com resina composta e coroa metálica. Todas as amostras foram submetidas a simulação de mastigação em 60 ciclos/min totalizando 300,000 ciclos. As amostras sobreviventes foram submetidas a teste de compressão com velocidade de 1,0 mm/min em máquina universal de ensaio. A carga foi aplicada a 135° em relação ao longo eixo do dente até a falha do dente. Os dados foram analisados por ANOVA (a=0,05). Após a simulação da mastigação foi observado: GNW: 100% de sobrevivência das raízes; GW: 70% de sobrevivência das raízes, e GDA e GIA: 80% de sobrevivência das raízes. O valor médio de resistência à fratura (N) foi de 280,6 (GNW), 239,0 (GW), 221,3 (GDA) e 234,1 (GIA) sem diferença significante entre os grupos (p=0,7476). Os resultados sugerem similar resistência à fratura em ambos os dentes fragilizados ou não-fragilizados em relação à técnica de reconstrução das paredes radiculares internas. Elevada incidência de fraturas catastróficas foram observadas nos dentes fragilizados sem a restauração das paredes radiculares internas.

Bonding Effectiveness of Universal Adhesive to Intracoronal Bleached Dentin Treated with Sodium Ascorbate

Abstract This study evaluated the effect of restorative protocol with sodium ascorbate on the shear bond strength (SBS) of a universal adhesive to intracoronal bleached dentin. One hundred-and-twenty bovine dentin fragments were randomly divided into 12 groups (n=10), according to the bleaching procedure (unbleached and bleached) and restorative protocol (no treatment, 10% sodium ascorbate -10SA, 35% sodium ascorbate -35SA and two-step etch-and-rinse -ER or one-step self-etch -SE Scotchbond universal adhesive approaches). Four whitening sessions were performed using 35% hydrogen peroxide. The samples from control groups were kept in relative humidity at 37 °C. Immediately after bleaching procedures, the assigned antioxidant solution was applied on dentin and restorative procedures were performed following either the ER or the SE approach. After 24 h, the specimens were subjected to SBS test. Data (MPa) were analyzed by ANOVA and Tukey's test (?=0.05). Lower SBS values were found for bleached specimens (8.54 MPa) compared with those unbleached (12.13 MPa) (p<0.05). The bond strength of the sodium ascorbate-treated groups was higher than those untreated, regardless of the strategy employed (p<0.05). Groups restored without sodium ascorbate showed lower bond strength values for both ER (8.32 MPa) and SE (8.28 MPa) adhesive strategies. The group treated with 10SA submitted to ER approach (10.14 MPa) was similar to untreated groups (p>0.05). It may be concluded that bond strength of composite resin to intracoronal dentin was affected by restorative protocol and reduced by bleaching.

Resumo Este estudo avaliou o efeito do protocolo restaurador empregando ascorbato de sódio na resistência ao cisalhamento do adesivo universal à dentina intracoronária clareada. Cento e vinte fragmentos de dentina bovina foram aleatoriamente divididos em doze grupos (n=10), de acordo com o procedimento clareador (clareados e não clareados) e protocolo restaurador (sem tratamento, ascorbato de sódio 10% (10AS), ascorbato de sódio (35AS) e estratégia de condicionamento total de dois passos (ER) ou estratégia autocondicionante de um passo (SE) com o sistema adesivo Scotchbond universal. Quatro sessões de clareamento foram realizadas empregando peróxido de hidrogênio a 35%. Os espécimes do grupo controle foram mantidos em umidade relativa a 37 °C. Imediatamente após os procedimentos de clareamento, as soluções antioxidantes selecionadas foram empregadas na dentina e os procedimentos restauradores foram realizados seguindo as estratégias ER ou SE. Após 24 h, os espécimes foram submetidos ao teste de resistência ao cisalhamento. Os dados (MPa) foram analisados pela ANOVA e teste de Tukey (?=0,05). Os menores valores de resistência ao cisalhamento foram encontrados para os espécimes clareados (8,54 MPa) comparados com aqueles não clareados (12,13 MPa) (p<0,05). A resistência de união dos grupos tratados com ascorbato de sódio foi maior que aqueles não tratados (p<0,05), independentemente da estratégia empregada. Grupos restaurados sem ascorbato de sódio demonstraram menores valores de resistência de união para ambas as estratégias adesivas ER (8,32 MPa) e SE (8,28 MPa) (p<0,05). O grupo tratado com ascorbato de sódio a 10% submetido à estratégia ER (10,14 MPa) foi similar ao não tratado (p>0,05). Pode ser concluído que a resistência de união da resina composta à dentina intracoronária foi afetada pelo protocolo restaurador e reduzida pelo clareamento.

Crown lengthening surgery and transurgical restoration

Introduction: The crown lengthening surgery and the transurgical restoration are alternative procedures to enable the restoration of teeth inaccessible to the conventional techniques and restore the lost biological space. Objective: This study aimed to present clinically the reconstruction of a right maxillary second molar through crown lengthening surgery associated with transurgical restoration with composite resin in a patient treated in the Integrated Clinics of the University of Ribeirão Preto. Case report: Patient E.H.C.V., female, aged 51 years, attended the dental clinic of the University of Ribeirão Preto. The anamnesis showed a favorable health history and the clinical examination showed great tooth crown destruction of tooth #17. The treatment planning included the crown lengthening periodontal surgery with regularization of alveolar bone on the buccal surface of tooth #17, rubber dam isolation, the restauration of the compromised area with composite resin, and suture in the same session. After 7 days, the sutures were removed and the restoration polished. Conclusion: It can be concluded that the use of this technique is a viable, fast, and satisfactory solution, with good results, favoring the health and aesthetics, returning function and better social life to the patient.

Effect of Fluoride Varnish Combined with Er:YAG Laser on the Permeability of Eroded Dentin: An In Situ Study

This study evaluated the combined effect of fluoride varnish and Er:YAG laser on the permeability of eroded bovine root dentin. After initial erosive challenge followed by a remineralization period, the specimens were divided in two groups according to the treatment - fluoride varnish and non-fluoride varnish - and were subdivided according to the irradiation protocol: Er:YAG laser (100 mJ, 3 Hz, 12.8 J/cm2per pulse, non-contact and defocus mode) and non-irradiated. After a lead-in period, 7 volunteers wore a palatal device containing 4 specimens that were subjected to erosive challenges. At the first experimental phase, 4 volunteers used specimens treated with fluoride varnish and fluoride varnish+Er:YAG laser and 3 volunteers used specimens treated with non-fluoride varnish and non-fluoride varnish+Er:YAG laser. After a washout period, volunteers were crossed to treatments, characterizing a 2x2 crossover experiment. At the end of the experimental phase, the quantitative response variable was obtained by permeability analysis and the qualitative response by scanning electron microscopy (SEM). Two-way ANOVA and Tukey-Kramer's test revealed that specimens treated with fluoride varnish+Er:YAG laser showed the lowest permeability and a significant difference was found between this group and the others. When varnish (fluoride/non-fluoride) was applied in the absence of Er:YAG laser, higher permeability was found when compared to the laser-treated groups. SEM evaluations showed partially or completely obliterated dentinal tubules when specimens were treated with fluoride varnish+Er:YAG laser. It may be concluded that Er:YAG laser was able to control the permeability of eroded root dentin and the combination with fluoride varnish increased laser action.

Resumo Esse estudo avaliou o feito combinado do verniz fluoretado ao laser de Er:YAG na permeabilidade da dentina radicular erodida. Fragmentos de dentina radicular bovina, foram submetidos a um desafio erosivo inicial com ácido cítrico, que foi seguido por um período de remineralização. Posteriormente, os espécimes foram divididos em relação aos tratamentos: verniz (fluoretado e não fluoretado) e subdivididos de acordo com a irradiação: laser de Er:YAG (100 mJ, 3 Hz, 12.8 J/cm2 por pulso, sem contato e modo não focado) e não irradiado. Após um período de lead in, 7 voluntários utilizaram um dispositivo palatino contendo 4 espécimes que foram submetidos a desafios erosivos. Na primeira fase do experimento, 4 voluntários utilizaram dispositivos com fragmentos tratados com verniz fluoretado e verniz fluoretado+laser de Er:YAG e 3 voluntários utilizaram espécimes tratados com verniz não fluoretado e verniz não fluoretado+laser de Er:YAG. Depois de um período de wash-out, os voluntários foram cruzados em relação aos tratamentos, caracterizando um experimento cross-over 2x2. Ao final de cada fase experimental, a variável resposta quantitativa foi obtida através da análise de permeabilidade e a qualitativa por microscopia eletrônica de varredura (MEV). A ANOVA dois critérios e teste de Tukey-Kramer revelou que as amostras tratadas com verniz fluoretado+laser de Er:YAG mostraram menor permeabilidade e uma diferença significativa foi encontrada entre este grupo, quando comparado aos demais grupos. Quando o verniz (fluoretado/não fluoretado) foram aplicados na ausência do laser de Er:YAG maiores valores de permeabilidade foram encontrados quando comparados com os grupos irradiados com o laser. A MEV demostrou túbulos dentinários parcialmente ou completamente ocluídos quando as amostras foram tratadas com verniz fluoretado+laser de Er: YAG. Pode-se concluir que o laser de Er:YAG foi capaz de controlar a permeabilidade da dentina radicular erodida e essa ação é aumentada quando o laser está associado ao verniz fluoretado.

Surface Roughness of Composite Resins Subjected to Hydrochloric Acid

The purpose of this study was to determine the influence of hydrochloric acid on surface roughness of composite resins subjected to brushing. Sixty samples measuring 2 mm thick x 6 mm diameter were prepared and used as experimental units. The study presented a 3x2 factorial design, in which the factors were composite resin (n=20), at 3 levels: microhybrid composite (Z100), nanofilled composite (FiltekTM Supreme), nanohybrid composite (Ice), and acid challenge (n=10) at 2 levels: absence and presence. Acid challenge was performed by immersion of specimens in hydrochloric acid (pH 1.2) for 1 min, 4 times per day for 7 days. The specimens not subjected to acid challenge were stored in 15 mL of artificial saliva at 37 oC. Afterwards, all specimens were submitted to abrasive challenge by a brushing cycle performed with a 200 g weight at a speed of 356 rpm, totaling 17.8 cycles. Surface roughness measurements (Ra) were performed and analyzed by ANOVA and Tukey test (p≤0.05). Surface roughness values were higher in the presence (1.07±0.24) as compared with the absence of hydrochloric acid (0.72±0.04). Surface roughness values were higher for microhybrid (1.01±0.27) compared with nanofilled (0.68 ±0.09) and nanohybrid (0.48±0.15) composites when the specimens were not subjects to acid challenge. In the presence of hydrochloric acid, microhybrid (1.26±0.28) and nanofilled (1.18±0,30) composites presents higher surface roughness values compared with nanohybrid (0.77±0.15). The hydrochloric acid affected the surface roughness of composite resin subjected to brushing.

Este estudo avaliou a influencia do ácido clorídrico na rugosidade superficial de resinas compostas submetidas a escovação. Sessenta corpos de prova medindo 2 mm de espessura x 6 mm de diâmetro foram confeccionados e utilizados como unidades experimentais. O presente estudo envolve uma análise fatorial 3x2, onde os fatores foram resina composta (n=20), com 3 níveis: resina composta microhíbrida (Z100), nanoparticulada (Filtek TM Supreme) e nanohíbrida (Ice); e desafio ácido (n=10), com 2 níveis: ausência e presença. O desafio ácido foi realizado por meio da imersão em ácido clorídrico (pH 1,2) por 4 h diárias, 1 min cada imersão, durante 7 dias. Os espécimes que não foram submetidos ao desafio ácido foram armazenados em 15 mL de saliva artificial a 37 °C. Todos os espécimes foram submetidos ao desafio abrasivo. O processo de escovação foi realizado com 200 g de peso, com velocidade de 356 rpm, totalizando 17,8 ciclos. As medidas de rugosidade superficial (Ra) foram realizadas e analisadas por meio da ANOVA e teste de Tukey (p<0,05). Os valores de rugosidade superficial foram maiores na presença (1,07±0,24)quando comparado com a ausencia do ácido hidroclorídrico (0,72±0,04). A resina microhíbrida (1,01±0,27) apresentou maior rugosidade superficial que as resinas nanoparticulada (0,68±0,09) e nanohíbrida (0,48±0,15) quando os espécimes não foram submetidos ao desafio ácido. Na presença do ácido hidroclorídrico, a resina microhíbrida (1,26±0,28) e a resina nanoparticulada (1,18±0,30) apresentou maior valor de rugosidade superficia comparado com a resina nanohíbrida (0.77±0.15). O ácido hidroclorídrico influenciou a rugosidade superficial da resina composta submetida a escovação.

Effects of various irrigation/aspiration protocols on cleaning of flattened root canals

This study aimed to evaluate, by means of scanning electron microscopy (SEM), the cleaning of flattened root canals, varying irrigation/aspiration protocols during biomechanical preparation. Thirdy human mandibular incisors were distributed into three groups (n = 10) according to the aspiration/irrigation protocols: conventional, conventional + brush, and apical negative pressure irrigation. Irrigation procedure was performed with 5 mL of 1% NaOCl at each change of instrument; final irrigation was conducted with 17% EDTA for 5 min. After biomechanical preparation, the roots were sectioned and prepared for SEM analysis. The images obtained were evaluated under 35× and 1,000× magnification by three calibrated examiners, following a double-blind design. All data were analyzed using Kruskal–Wallis and Dunn’s post hoctests (α = 0.05). Canals wherein the conventional method and apical negative pressure irrigation were employed revealed less debris, statistically different from the conventional + brush group (p < 0.05). Regarding the presence of smears, apical negative pressure irrigation was more effective in cleaning, showing lowest scores (p < 0.05), compared with the other tested protocols. Comparing each root canal third revealed that the apical portion was difficult to clean as all the tested protocols showed similar high scores (p > 0.05), both for the presence of debris and smear layer. In conclusion, although none of the studied irrigation/aspiration protocols have completely cleaned flattened root canals, apical negative pressure irrigation was more effective in smear layer removal, whereas the conventional + brush protocol was the least effective in removing the debris and smear layer.

Impact of Intracoronal Dentin Treatment Prior to Bleaching on Bond Strength of Restorative Materials

Surface treatment of dentin before the bleaching procedure may affect its permeability and influence the bond strength of restorative materials. This study evaluated the influence of surface treatment before the bleaching on shear bond strength (SBT) of restorative materials to intracoronal dentin. Dentin slabs were subjected to surface treatment: no bleaching (control - CON), no surface treatment + bleaching (HP), 37% phosphoric acid + bleaching (PA) and Er:YAG laser + bleaching (L). After the bleaching procedure, specimens (n=10) were restored with: microhybrid composite resin (MH), flowable composite resin (F), and resin-modified glass-ionomer cement (RMGIC). The shear test was carried out. ANOVA and Tukey's test (α=0.05) showed significant difference for surface treatment and restorative materials (p<0.05). CON presented higher STB and was statistically different from HP (p<0.05). PA and L showed intermediate values and were statistically similar to CON and HP (p>0.05). STB for MH and F were higher than RMGIC (p<0.05), and did not differ from each other (p>0.05). The surface treatments with phosphoric acid and Er:YAG laser before the bleaching procedure provided shear bond strength at the same level of unbleached dentin and the composite resins presented superior bond strength to the intracoronal dentin.

O tratamento superficial da dentina previamente ao clareamento pode afetar a sua permeabilidade e influenciar a resistência de união de materiais restaurados. Este estudo avaliou a influência do tratamento superficial antes do clareamento na resistência ao cisalhamento (RC) de materiais restauradores à dentina intracoronária. Fragmentos de dentina foram submetidos ao tratamento de superfície: não clareadas (controle - CON), sem tratamento de superfície + clareamento (HP), ácido fosfórico 37% + clareamento (AF), e laser Er:YAG + clareamento (L). Após o procedimento clareador, os espécimes foram restaurados com (n=10): resina composta micro-híbrida (MH), resina composta fluida (F), e cimento de ionômero de vidro modificado por resina (CIVMR). O teste de cisalhamento foi realizado. ANOVA e teste de Tukey (α=0,05) mostraram diferença significante para tratamento superficial e material restaurador (p<0,05). O grupo controle apresentou maior resistência de união e foi estatisticamente diferente de HP (p<0,05). AF e L mostraram valores intermediários e foram similares ao CON e HP (p>0,05). A resistência de união para MH e F foi maior que CIVMR (p<0,05), e não diferiram entre si (p>0,05). O tratamento da superfície dentinária com ácido fosfórico e laser Er:YAG previamente ao clareamento promoveu resistência de união ao nível da dentina não clareada e a adesão à dentina intracoronária foi superior com as resinas compostas.

Ultra-thin porcelain laminates to restore esthetics of anterior teeth: case report

Introduction: The ultra-thin porcelain laminates provide the esthetic harmony to the smile compromised by the presence of diastema between maxillary incisors. Objective: To report the dental aesthetic recovery with ultra-thin porcelain laminates, so-called "contact lenses". Case report: Patient sought treatment reporting presence of diastema between the anterior teeth. After the clinical examination, impressions were made to obtain study models and diagnostic wax-up. Home bleaching was conducted using 10% carbamide peroxide for 21 days. Next, the mock-up with bisacrylic self-curing composite resin and the functional impression were conducted. For cementation, dental surfaces were etched with 37% phosphoric acid followed by applying the adhesive system. The resin cement was inserted within internal part of the contact lenses previously treated with hydrof luoric acid and silane, and the prosthetic samples were positioned over the labial surfaces of the anterior teeth. After light-curing, the finishing procedure was performed. Conclusion: Ultra-thin porcelain laminates (contact lenses) were viable, efficient, and conservative procedures for recovering dental esthetic, with no need of invasive procedures.

Influence of Apical Enlargement in Cleaning of Curved Canals Using Negative Pressure System

This study aimed to evaluate, by scanning electron microscopy (SEM), the cleaning of canal walls with moderate curvature subjected to biomechanical preparation with different final diameters using apical negative pressure irrigation. Thirty-two mesiobuccal roots of molars were divided into 4 groups (n=8) according to the instrument's final diameter: GI: 30.02, GII: 35.02, GIII: 40.02 and GIV: 45.02. Irrigating procedure was performed at each change of instrument with 1% NaOCl using the Endovac system. Final irrigation was conducted with 17% EDTA for 5 min. The SEM photomicrographs were evaluated under 35× and 1000× magnification, by three calibrated examiners, in a double-blind design. Data were submitted to Kruskal-Wallis and Dunn's post hoc tests (α=0.05). Canals instrumented with 30.02 and 35.02 final diameters showed more debris, statistically different from the other groups (p<0.05). Comparing each root canal third, for the cervical and apical portions no statistically significant difference (p>0.05) was found among the four groups. Regarding the presence of smear layer, canals with 30.02 final diameter showed the highest scores, statistically different from the 45.02 group (p<0.05) and similar to the 35.02 and the 40.02 groups (p>0.05). Although none of the studied diameters completely removed debris and smear layer, it may be concluded that instrumentation with higher final diameters was more effective in cleaning the root canals with moderate curvature.

Este estudo buscou avaliar, por meio de microscopia eletrônica de varredura (MEV), a limpeza das paredes de canais com curvatura moderada, submetidos ao preparo biomecânico com diferentes diâmetros finais utilizando-se irrigação por pressão apical negativa. Trinta e duas raízes mésio-vestibulares de molares foram divididas em 4 grupos (n=8) de acordo com o diâmetro final dos instrumentos: GI: 30.02, GII: 35.02, GIII: 40.02 e GIV: 45.02. O procedimento de irrigação foi realizado a cada troca de instrumento com NAOCl 1% utilizando o sistema EndoVac. A irrigação final foi conduzida com EDTA 17% por 5 min. As microfotografias de MEV foram avaliadas sob aumentos de 35× e 1000×, por três examinadores calibrados, em estudo duplo-cego. Os dados foram submetidos ao teste de Kruskal-Wallis e pós-teste de Dunn (=0,05). Os canais instrumentados com diâmetros finais de 30.02 e 35.02 demonstraram mais debris, estatisticamente diferente dos demais grupos (p<0,05). Comparando-se cada terço do canal radicular, para as porções cervical e apical não foi encontrada diferença estatisticamente significante (p>0,05) entre os quatro grupos. Com relação à presença de smear layer, canais com diâmetro final de 30.02 demonstraram os maiores scores, estatisticamente diferente do grupo 45.02 (p<0,05) e similar aos grupos 35.02 e 40.02 (p>0,05). Apesar de nenhum dos diâmetros estudados ter removido completamente os debris e a smear layer, pode ser concluído que a instrumentação com diâmetros finais maiores foi mais efetiva na limpeza dos canais radiculares com curvatura moderada.

The influence of mouthrinses and simulated toothbrushing on the surface roughness of a nanofilled composite resin

The aim of this study was to determine the influence of mouthrinses on the surface roughness of a nanofilled composite resin after toothbrushing. One hundred nanofilled composite resin specimens were prepared and randomly distributed into two groups-brushed and non-brushed-and then assigned to five subgroups, according to the mouthrinse solutions (n = 10): Colgate Plax Fresh Mint, Oral B, Cepacol, Colgate Plax, and artificial saliva. Each sample was immersed in 20 mL of the mouthrinses for 1 minute, 5 days per week, twice a day, for a 3-week period. The control group used in the study was one in which the specimens were not subjected to brushing and remained only in artificial saliva. Toothbrushing was performed once a week for 1 minute, for 3 weeks. Surface roughness measurements (Ra) were performed after the immersion period and toothbrushing, by means of a profilometer. Data were analyzed by two-way ANOVA and Tukey's test. Analysis revealed that the association between toothbrushing and Colgate Plax Fresh Mint produced the lowest surface roughness (p < 0.05). All other groups tested (Oral B, Cepacol, Colgate Plax, artificial saliva) exhibited no statistically significant differences between surfaces, whether subjected to toothbrushing or not (p < 0.05). It was concluded that the surface roughness of the nanofilled composite resin tested can be influenced by the mouthrinse associated with toothbrushing.