Desensitizing Agent Previously Applied During In-Office Bleaching: A Double-Blind Randomized Clinical Trial

Abstract Objective: To compare the clinical effect of two desensitizing agents used before the application of a bleaching gel based on 35% hydrogen peroxide (HP). Material and Methods: 30 patients were selected, and two desensitizing agents with different mechanisms of action were applied: Fluorine Neutral 2% (FN), which acts by blocking dentinal canaliculi while Potassium Nitrate 5% with 2% Sodium Fluoride (PN/SF) that acts in nerve transmission and blockade. Desensitizers were used before the application of 35% HP. For whitening, three clinical sessions were performed, with an interval of seven days, with three applications of the bleaching gel for 15 minutes, totaling 45 minutes/session. Tooth sensitivity (TS) was assessed with the numerical analog scale, and a spectrophotometer was used to obtain the color variation (ΔE). ΔE were submitted to ANOVA and Tukey test (p<0.05), and TS data were submitted to a two-way ANOVA analysis. Results: For sensitivity experience, the Tukey test indicated differences between PN/SF and the placebo I, but there was no statistically significant difference between FN and the placebo II. The TS was lower when the desensitizing gel was used during the bleaching procedure compared to after treatment, regardless of the desensitizing agents. Conclusion: PN/SF before in-office tooth bleaching can reduce TS intensity, and the use of desensitizing gel before bleaching did not affect the bleaching efficacy.

Surface roughness evaluation and whitening efficiency on tooth enamel after using whitening toothpaste: a randomized double-blinded study

The aim of this randomized double-blinded study was to evaluate the enamel surface roughness and color change after one month of whitening toothpaste use and the color stability obtained 1 month after its interruption. 30 volunteers were divided into 3 groups (n = 10) corresponding to the dentifrices: 1) Colgate Total 12 Clean Mint (TD) (Control), 2) Colgate Luminous White (LW) and 3) Sensodyne Whitening Extra Fresh (SB). The volunteers were impression with addition silicone to obtain an epoxy resin replica of the upper central incisor for the initial surface roughness evaluation using a profilometer and the initial color of the incisors and canines was evaluated with a spectrophotometer after one week of wash-out. After 1 month, the color of the central incisors and canines was measured again, and the volunteers were molded to obtain a second replica to the final roughness analysis. Data were submitted to ANOVA-one way (p≤0.05). The results showed that there was no statistical difference between the dentifrices for color difference and surface roughness for all the studied conditions. It was possible to conclude that the whitening dentifrices used in this study were not able to alter the initial color of the teeth and did not cause changes in the surface roughness of enamel.

Ellagic acid on the quality of the adhesive interface of class I composite resin restorations after aging

To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

Influence of cavo superficial enamel acid-etching on the microtensile bond strength of low-shrinkage composite resin / Influência do condicionamento ácido do ângulo cavo superficial na resistência adesiva de restaurações em um compósito de baixa contração de polimerização

Introduction: To prevent the shrinkage stresses produced during polymerization, composite resins of low polymerization shrinkage were developed. Objective: To evaluate the microtensile bond strength in class I cavities restored by acid-etching the cavosurface angle and with composite resins indicated for posterior teeth. Material and method: 48 healthy molars were selected and divided into six groups (n = 8), considering that the cavosurface enamel of three groups was etched with 35% phosphoric acid. The teeth were restored with the Clearfil SE Bond adhesive system and Filtek Z350 XT, Empress Direct, and Charisma Diamond composite resins, which were light-cured for 40 seconds. After 24 hours, the teeth were taken to a cutting machine, which produced sections in the buccolingual and mesiodistal directions. This resulted in toothpicks of 0.9×0.9 mm that were taken to the universal testing machine for the microtensile bond strength test. Statistical analysis was performed with ANOVA and Tukey's test (p < 0.05). Result: There was no statistically significant difference between the groups evaluated. Conclusion: Acid-etching the cavosurface angle did not affect the performance of restorations, probably due to the adhesive system used.

Introdução: Com o intuito de se evitar as tensões geradas durante a contração de polimerização das resinas compostas, foram desenvolvidas as resinas compostas de baixa contração de polimerização. Objetivo: Avaliar a resistência à microtração em cavidades classe I restauradas com tratamento ácido do ângulo cavo superficial e resina composta indicada para dentes posteriores. Material e método: Foram selecionados 48 molares hígidos que foram divididos em 6 grupos (n=8), sendo que 3 desses tiveram o esmalte cavo superficial condicionado com ácido fosfórico a 35%. Os dentes foram restaurados com o sistema adesivo Clearfil SE Bond e as resinas compostas Filtek Z350 XT, Empress Direct e Charisma Diamond, fotoativadas por 40 segundos. Após 24 horas, os dentes foram levados para máquina de corte, na qual foram realizados cortes no sentido vestíbulo-lingual e no sentido mésio-distal obtendo - se palitos de 0,9×0,9 mm que foram levadas para a máquina de ensaio universal para a realização do teste de microtração. Para análise estatística foi realizado análise de variância e teste de Tuckey (p < 0,05). Resultado: Não houve diferença estatística significante entre os grupos avaliados. Conclusão: O condicionamento ácido do ângulo cavo superficial não influenciou no desempenho das restaurações provavelmente devido ao sistema adesivo utilizado.

Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up

Abstract Objective To clinically assess the effect of desensitizing gels and dentifrices on the reduction in pain sensitivity and color variation during tooth bleaching. Methodology A total of 108 volunteers were randomly separated into the following groups of n=12: GT/S-glycerine and thickener/sucralose; NF/S-potassium nitrate and sodium fluoride/sucralose; NA/S-potassium nitrate and arginine/sucralose; GT/AC-glycerine and thickener/arginine and calcium carbonate; NF/AC-potassium nitrate and sodium fluoride/arginine and calcium carbonate; NA/AC-potassium nitrate and arginine/arginine and calcium carbonate; GT/PN-glycerine and thickener/potassium nitrate; NF/PN-potassium nitrate and sodium fluoride/potassium nitrate; and NA/PN-potassium nitrate and arginine/potassium nitrate. Sensitivity was assessed with the numerical analogue scale, and color variation (ΔE) was measured with a spectrophotometer. The sensitivity values obtained were subjected to a multivariate analysis of variance (MANOVA) and color variation values were subjected to a randomized analysis of variance (p<0.05). Results The NF/AC, NA/AC, NF/PN, and NA/PN groups presented lower sensitivity values and reduced sensitivity compared to those of the other groups throughout the clinical sessions. None of the groups showed sensitivity at the 24-week assessment. Statistically, no significant difference were observed in the color values among the groups four weeks after the beginning of bleaching (p=0.074). Additionally, the color assessment of all groups was statistically similar four weeks (p=0.084) and 24 weeks (p=0.118) after the beginning. Conclusion Our results indicate that adding NF/S, NA/S, NF/AC, and NA/AC desensitizers to tooth bleaching protocols reduces pain sensitivity without affecting its effectiveness.

Conservative Substitution of Fractured Ceramic Onlays Using Self-Adhesive Cement: Case Report / Substituição Conservadora de Onlays Cerâmicas Fraturadas Utilizando Cimento Autoadesivo: Relato de Caso

The advances in bonding of ceramics and self-adhesive resin cements to tooth structure make this treatment a feasible alternative to restore posterior teeth. This case report described the removal of two fractured onlays and the fabrication of new lithium disilicate onlays cemented with self-adhesive resin cement. The rationale for various choices in this treatment protocol is detailed with reference to the pertinent literature. It is concluded that the clinical success of the technique depends on the correct identification of the case for which this treatment is appropriate and on the successful execution of the clinical steps involved. (AU)

Os avanços na adesão de cerâmicas e cimentos resinosos autoadesivos à estrutura dentária tornam este tratamento uma alternativa viável para restaurar os dentes posteriores. Ester relato de caso descreveu a remoção de duas onlays fraturadas e confecção de novas onlays de dissilicato de lítio cimentadas com cimento resinoso auto-adesivo. A justificativa para várias escolhas neste protocolo de tratamento é detalhada com referência à literatura pertinente. O sucesso clínico da técnica depende da correta identificação do caso para o qual este tratamento é adequado e da execução bem-sucedida das etapas clínicas envolvidas. (AU)

Evaluation of Finishing/Polishing Techniques on Low-Shrink Posterior Restorative After Mechanical Cycling / Avaliação de Técnicas de Acabamento/Polimento em Restaurações Posteriores de Baixa Contração Após Ciclagem Mecânica

The aim of this study was to evaluate the surface roughness of a silorane and methacrylate-based composite resins subjected to different finishing/polishing techniques. Twelve disk specimens were prepared from each composite resin: P90®, Z350® and Charisma, divided into 12 groups according to the finishing/polishing technique: no finishing/polishing (control); finishing with 1112 FF diamond burs; finishing with 1112 FF diamond burs associated to Enhance/Pogo; finishing with 1112 FF diamond burs associated to Enhance/Pogo/Polishing/Poli I and II pastes/Fotogloss. After initial readouts of surface roughness, the specimens were subjected to mechanical cycling (1.200.000 cycles) and immediately subjected to final roughness readouts. Surface roughness means was statistically analyzed by ANOVA and Tukey-Kramer test (α=0.05). SEM images were realized after finishing/polishing and after mechanical cycling. The P90 composite showed surface roughness values similar to other investigated composites. However, significant difference was observed in finishing/polishing techniques. The diamond burs group showed the highest surface roughness differing from the other composite resins (α < 0.05). Enance/Pogo showed the lowest results, which presented no difference compared to the polishing paste group (α > 0.05). The low-shrink posterior restorative showed similar surface roughness when compared to dimethacrylate composite resins and suitable to posterior restorations. (AU).

O objetivo deste estudo foi avaliar a rugosidade superficial de resinas compostas à base silorano e metacrilato submetidas a diferentes técnicas de acabamento/polimento. Foram preparadas 12 amostras de disco de cada resina composta: P90®, Z350® e Carisma, divididas em 12 grupos de acordo com a técnica de acabamento / polimento: sem acabamento / polimento (controle); acabamento com ponta diamantada 1112 FF; acabamento com ponta diamantada 1112 FF associada a Enhance / Pogo; acabamento com ponta diamantada 1112 FF associada a Enhance / Pogo / Polishing / Pastas Poli I e II / Fotogloss. Após as leituras iniciais da rugosidade da superfície, os espécimes foram submetidos a ciclos mecânicos (1.200.000 ciclos) e submetidos imediatamente a leituras de rugosidade final. As medias de rugosidade superfícial foram analisadas estatisticamente por ANOVA e teste de Tukey-Kramer (α = 0,05). As imagens de MEV foram realizadas após o acabamento / polimento e após a ciclagem mecânica. O compósito P90 mostrou valores de rugosidade superficial semelhantes a outros compósitos investigados. Tough, mostrou diferença significativa nas técnicas de acabamento / polimento. O grupo de pontas damantadas apresentou maior rugosidade superficial que diferiu das outras resinas compostas (α <0,05). Enance / Pogo mostrou os menores resultados, que não apresentaram diferença em relação ao grupo de pasta de polimento (α> 0,05). O material restaurador posterior de baixa contração apresentou rugosidade superficial semelhante quando comparado as resinas compostas de dimetacrilato e são restaurações adequadas para região posterior. (AU).

Effects of primer excess on marginal adaptation, nanoleakage and bond strength of adhesive systems after aging

There is no consensus about the amount of primer inserted into the cavity. Aim: This study aimed to evaluate the effects of the amount of primer used on dentin microtensile bond strength (µTBs), nanoleakage and marginal sealing, following thermomechanical aging. Methods: 48 human third molars were selected and a box-shaped class I cavity was constructed to maintain enamel margins. Teeth were randomly assigned to 6 experimental groups (n=8). For the bonding protocols of the restorative procedure, two adhesive systems were used: three-step etch-and-rinse and two-step self-etch. Epoxy resin replicas of the occlusal surface were made, and the specimens were submitted to thermomechanical aging. Newer replicas were obtained after thermomechanical aging, and marginal adaptation was observed using SEM. To obtain sections (0.7 x 0.7 mm) for testing at a tension of 0.5 mm/min, teeth were serially sectioned in the buccallingual direction, parallel to the occlusal surface. Failure mode was then obtained. For nanoleakage evaluation, one section of each tooth was immersed in AgNO3 and evaluated using SEM. The µTBs data were submitted to a two-way ANOVA and Tukey's test (α= 0.05) Results: One drop of primer promoted higher µTBs than two or three drops. Besides, the three-step etch-and-rinse promoted greater µTBs (19.78) than the two-step self-etch adhesive (12.23). The increase in the amount of primer was directly proportional to the increase of infiltration. All groups exhibited more gaps after thermomechanical aging. Conclusion: Using an excess of primer is not recommended because it reduces the µTBs and forms an unsatisfactory hybrid layer

Resolution of a fluorosis case through the association of minimally invasive techniques: microabrasion and tooth bleaching

Color changes may interfere with smile balance and they represent a clinical challenge to dentists. Dental fluorosis originates from intrinsic factors and it is a disorder of enamel formation during the phase of teeth development, resulting in the change of enamel color. This clinical case report aimed to present the resolution of a case of dental fluorosis through the association of minimally invasive techniques, namely microabrasion and tooth bleaching. A 27-year-old male patient sought the dental clinic of the School of Dentistry of Piracicaba (FOP - UNICAMP, Brazil) presenting striped and symmetrical white stains and generalized chromogenic biofilm. After anamnesis and clinical examination, the patient was diagnosed with fluorosis stains. Initially, adequacy of the oral environment was performed with prophylaxis and supragingival scraping. Then, the enamel microabrasion technique was performed with 6% hydrochloric acid associated with silicon carbide (Whiteness RM - FGM) and supervised at-home bleaching was performed with 16% carbamide peroxide (Whiteness Simple 16% - FGM). In conclusion, the treatment performed reestablished the aesthetics and harmony of smile color with minimally invasive procedures without causing tooth sensitivity

Minimally invasive approach to diastema closure using lithium disilicate porcelain veneers: clinical report / Abordagem minimamente invasiva para fechamento de diastema usando laminados cerâmicos de dissilicato de lítio: relato clínico

Objective: Numerous advances in dentistry techniques and material have allowed patients to have not only a functional but also an aesthetic smile in a conservative way. This case report describes a treatment with ceramic laminates to solve the aesthetic problems of an 18-year-old male dissatisfied with his smile. Following the correct protocols, using minimally invasive abrasions, ceramic laminates, and strong adhesion between porcelain and dental enamel can provide predictable results and clinical longevity through follow-up. (AU)

Objetivo: Devido aos inúmeros avanços das técnicas e materiais odontológicos tem sido possível proporcionar ao paciente não só a função, mas também a estética do sorriso de maneira minimamente invasiva. Esse relato de caso descreve o tratamento com laminados cerâmicos para resolver problemas de um paciente de 18 anos gênero masculino insatisfeito com o seu sorriso. Seguindo os protocolos corretamente, utilizando desgastes minimamente invasivos, laminados cerâmicos, e forte adesão entre a porcelana e o esmalte dental, é possível obter resultados previsíveis e longevidade clínica mediante acompanhamento. (AU)

Influence of whitening dentifrices and mechanical brushing on color change and surface roughness of bulk fill resins

The use of whitening dentifrices during oral hygiene may cause surface modifications such as color change (ΔE) and increase surface roughness (Ra) of composite resin. Aim: This study aimed to evaluate the effect of whitening dentifrices and mechanical brushing on color change and surface roughness of Bulk Fill (Filtek Bulk Fill - F) and (Aura Bulk Fill - A) composite resins. Materials and methods: Sixty cylindrical specimens were fabricated of each composite resin. After initial color evaluations (Konica Minolta CM-700d), with D65 standard illuminant, and the surface roughness (Surfcorder SE 1700, Kosalab), the specimens were assigned (n=10) according to the whitening dentifrice used: True White (T), Colgate Total 12 Professional Whitening (D), Luminous White Advanced (L). Specimens were submitted to mechanical brushing (10,000 cycles); new color and surface roughness evaluations were taken. Data were analyzed by ANOVA, Duncan test and Dunnet test were used to identify differences between groups (α=5%). Results: The results showed that the tooth brushing time promoted a significant increase in ΔE of the FT group. The FD group exhibited intermediate values of ΔE and was similar to all groups tested. There was a significant increase in the surface roughness of the AD and AT groups after the mechanical tooth brushing. Conclusion: The results showed no significant changes were observed in surface roughness for F groups after toothbrushing. It be concluded that the color change and surface roughness of the composite resins after toothbrushing are dependent on the interaction between the composition of the composite resin and the characteristics of the dentifrice

Influence of enamel acid-etching on mechanical properties and nanoleakage of resin composite after aging

The aim of this study was to evaluate how acid-etching of the cavosurface enamel in Class I resin composite restorations influences the bond strength to the pulpal wall and the restoration, Knoop microhardness and nanoleakage after thermomechanical aging. For this research 76 fresh human molars were selected and restored with Silorane or Clearfil SEBond/Z350XT composite divided in 4 groups (Silorane system restored with or without enamel cavosurface acid-etching and Clearfil SEBond/Z350XT with or without enamel cavosurface acid-etching). To induce artificial aging, samples were subjected to thermomechanical cycling through 200,000 and thermal cycling between 5 and 55 °C with 30 second filling and 15-second drainage steps. Microhardness and microtensile bond strength were evaluated in 32 teeth (n=8) each and nanoleakage evaluation was performed in 12 teeth (n=3). Samples restored by Clearfil SEBond/Z350 XT without cavosurface acid-etching showed significantly lower microtensile bond strength results. The resin composite Z350XT presented higher values of Knoop microhardness. It was observed little or no infiltration for Silorane groups and moderate infiltration for Clearfil SE Bond groups. Acid-etching of the cavosurface enamel during restoration procedure with Clearfil Se Bond resulted in a stronger bond after thermomechanical cycling. Silorane groups showed less infiltration than Clearfil SE Bond groups (AU)

Influência da camada híbrida na resistência à microtração de sistemas adesivos após armazenamento / Hibrid layer influence in bond systems microtensile test after storage

O objetivo deste estudo foi avaliar a resistência à microtração de sistemas adesivos em função da presença ou não da camada de colágeno e do tempo de armazenamento. Para tanto foram utilizados 24 terceiros molares restaurados utilizando-se diferentes sistemas adesivos, com ou sem tratamento prévio com NaOCl, e armazenados por 24 horas e 12 meses. Os valores de resistência foram submetidos à análise estatística. O tratamento prévio com NaOCl não foi significativo em 24 horas. Entretanto, este tratamento manteve resultados satisfatórios de adesão após 12 meses para todos os sistemas adesivos, com exceção apenas do Prime & Bond NT.

The aim of the present study was to evaluate the microtensile bond strength of different bond systems due to presence or absence of the collagen layer and storage time. Therefore, 24 third molars were restored using different bond systems, with or without pretreatment with NaOCl, and stored for 24 hours and 12 months. The microtensile strength values were subjected to statistical analysis. The pretreatment with NaOCl was not significant in 24 hours. However, this pretreatment remained satisfactory bond results after 12 months for all bond systems, except for Prime & Bond NT.

Reforço intrarradicular de raízes debilitadas / Intra-root strengtening of weakened roots

A instrumentação dos canais radiculares através do uso de lima única em movimento recíproco vem se popularizando devido à redução do tempo de trabalho e menor tendência de fraturas dos instrumentos. Antes de escolher o sistema que vai utilizar, o cirurgião- -dentista deve conhecer as capacidades e limitações de cada sistema baseado em evidências científicas. Esse artigo realizou uma revisão de literatura sobre o movimento recíproco para instrumentação do sistema de canais radiculares apontando as vantagens e desvantagens da utilização dessa cinemática de instrumentação.

The canal’s instrumentation by using single file in reciprocation movement is gaining popularity due to the reduction of working time and less prone to fractures of the instruments. Before choosing which system will use, the dentist must know the capabilities and limitations of each system based on scientific evidence. This article reviews the literature on the reciprocation movement pointing out the advantages and disadvantages of this different kinematic instrumentation.

Resolução estética: naturalidade com coroas cerâmicas / Esthetic solution: nature-like results with ceramic crowns

A valorização da estética do sorriso favorece o interesse pelos materiais cerâmicos na reabilitação dental, em função de resultados naturais e fáceis de ser alcançados. As propriedades ópticas semelhantes às da estrutura dentária, associadas à capacidade mecânica proporcionada pelas cerâmicas reforçadas (metal free), têm possibilitado resoluções estéticas sem comprometimento funcional. Dessa forma, este relato de caso clínico tem por objetivo descrever uma resolução estética com indicação de coroas cerâmicas metal free para resolução estético-funcional do sorriso, discutindo indicações e características, assim como as técnicas empregadas para o uso desses materiais

The appreciation of the smile esthetics favors the interest for ceramic materials used oral rehabilitation, since the clinician can achieve natural, esthetic results. Optical properties similar to tooth structure in association with the mechanical strength provided by reinforced all-ceramic restorations produce esthetic results without functional impairment. Thus, the aim of this case report is to describe an esthetic indication of all-ceramic crowns to reach esthetic, functional smile resolution and to discuss its indications and characteristics, and the technique used to these materials

Influence of remaining coronal structure and finish line on the fracture strength of roots restored with metallic posts

The purpose of this study was to evaluate the fracture strength of roots that were prosthetically restored with metallic posts with or without any remaining coronal structure and with different finish lines. Sixty bovine incisors were sectioned below the cementoenamel junction, endodontically treated, and randomly divided into six experimental groups (n = 10) containing teeth with or without any remaining coronal structure, and with a beveled shoulder, a bevel, or a shoulder finish line design. The metallic posts were luted with dual-cured resin cement. The cores were made with composite resin, and metal crowns were cemented with zinc phosphate cement. The specimens were subjected to a tangential compressive load (135º angle) at a crosshead speed of 0.5 mm/min until failure, using a universal testing machine. The fracture strength data were analyzed using the ANOVA and LSMeans (least square means) tests (α= 0.05). The data indicated that the teeth with 2 mm of remaining coronal structure showed the highest fracture strength values when compared with the teeth without any remaining structure (p < 0.05). As to the different finish line designs, the highest fracture strength values were obtained for the beveled shoulder, followed by the bevel and then by the shoulder designs (p < 0.05). It may be concluded that, to increase fracture strength, a beveled shoulder and 2 mm of remaining coronal structure are the ideal conditions.

Restauração com pinos intrarradiculares anatômicos em grandes destruições coronárias / Restoration with intraradicular anatomical posts in flared root canals

o tratamento endodôntico em dentes com grande destruição coronária é um procedimento clínico comum no cotidiano das clínicas odontológicas. Na maioria destas situações clínicas, há a indicação do uso de retentor intrarradicular para dar estabilidade e retenção à restauração. Uma das técnicas propostas para o tratamento de canais amplos é a utilização de um pino de fibra de vidro com módulo de elasticidade próximo ao da dentina, remodelado com resina composta para preencher o espaço existente no canal radicular alargado. Esta técnica reduz quantidades excessivas de cimento que serviriam para substituir a estrutura dental perdida e permite uma boa adaptação no conduto radicular, criando condições favoráveis para retenção do pino. O objetivo deste trabalho foi demonstrar a técnica de anatomização de pinos intrarradiculares estéticos com resina composta, em incisivo anterior com grande destruição coronária. A utilização de um pino de fibra de vidro anatômico foi a alternativa indicada para a resolução clínica de forma a proteger o remanescente dental enfraquecido, além de obter estética aliada a um prognóstico favorável.

Root canal therapy in teeth with large coronal destruction is a common clinical precedure in the daily dental clinics. In most of these conditions, there is an indication of the use of intra-radicular post for stability and retention for the restoration. One of the techniques proposed for the treatment of enlarged channels, is the use of a fiber glass with modulus of elasticity similar to dentin, restored with composite resin to fill the space between the root canal extended. This technique reduces excessive amounts of cement that would serve to replace the lost tooth structure and allows a good adaptation in the root canal, creating favorable conditions for retention of the post. The objective was to demonstrate the technique of anatomization intraradicular aesthetic post with composite resin in anterior incisor with large coronal destruction. The use of a fiber glass anatomical was the alternative used for clinical resolution in order to reinforce the remaining tooth structure weakened, returning him to function without requiring the removal of sound tooth structure, and aesthetics combined with a more favorable prognosis.

Influence of selective acid etching on microtensile bond strength of a self-adhesive resin cement to enamel and dentin

Aim: To evaluate the selective acid etching of enamel and dentin on microtensile bond strength (¦ÌTBS) of a self-adhesive resin cement. Methods: Forty-eight bovine teeth were selected and had the buccal surface ground to obtain a flat dentin (n=24) or enamel (n=24) surface. Z250 composite resin blocks (4 x 3 x 8 mm) were prepared for cementation at enamel and dentin. Each substrate received three experimental resin cementation strategies: 1) 37% phosphoric acid etching before the application of RelyX Unicem; 2) application of RelyX Unicem alone; 3) RelyX ARC as a control. Samples were light-cured using a halogen light (Optilux 501, 700mW/cm2), for 40 s. Hourglass-shaped specimens were obtained and submitted to a tensile strength at a crosshead speed of 0.5 mm/min in a universal testing machine. For statistical analysis, data were submitted to ANOVA and Tukey¡¯s test at a pre-set alpha (¨¢=0.05). Results: RelyX Unicem showed similar bond strength value (16.5 MPa) when compared to the pretreatment with acid etching (11.9 Mpa) and to the conventional resin cement (18.1 MPa) for enamel. All luting strategies presented similar dentin bond strength, but significantly lower than enamel bond strength. Conclusions: Acid etching prior to RelyX Unicem application did not improve microtensile bond strength for enamel and dentin.

Restauração estética direta de dente anterior fraturado: relato de caso clínico / Direct aesthetic restoration of fractured anterior teeth: case report

O protocolo restaurador direto com resina composta para dentes anteriores fraturados é um desafio na Odontologia Adesiva atual, já que existem vários compósitos à disposição no mercado, com características ópticas e mecânicas cada vez mais semelhantes às da estrutura dentária. Dessa forma, a técnica de estratificação em camadas de resina composta torna-se eficiente para uso na clínica odontológica. Nesse artigo, o caso clínico apresentado abordará a restauração estética de um incisivo medial fraturado, com o procedimento de estratificação de resina composta, trabalhando os conceitos de translucidez e opacidade para uma adequada reabilitação dentária de forma estética e funcional.

Uso de princípios de ilusão óptica no contorno cosmético: previsibilidade e excelência estética / Using principles of optical illusion for cosmetic recontouring: predictability and esthetic excellence

O contorno cosmético é uma técnica operatória que requer do profissional amplo conhecimento de estética e reflexão da luz, pois implica desgaste irreversível da estrutura dental sadia. Este artigo relata um caso clínico de contorno cosmético que ilustra as possibilidades de remodelação estética do sorriso guiadas por princípios de ilusão de óptica, na qual foi possível, mediante a realização de desgastes em esmalte, obter resultados satisfatórios com previsibilidade.

Cosmetic recontouring is a technique that demands comprehensive skills and knowledge about esthetics light dynamics by the professional, since irreversible reduction of tooth sound structure is required. This paper is a case report of the cosmetic contouring showing the possibilities of esthetic recontouring of the smile following principles of optical illusion, from which it was possible through enamel reduction to achieve satisfactory, predictable results.