Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Amalgam and the Minamata Converntion on Mercury / 中华口腔医学杂志

The restoration of teeth with direct restorative materials has changed significantly since the 1980s. Resin composite has replaced amalgam alloy as the material of choice in many clinical situations. The emergence of such factors as aesthetics, minimally invasive dentistry, environmental and public health has changed its status as a prosthetic material in some clinical situations. The Minamata Convention on Mercury signed in 2013 will advise every country to phase down the future use of amalgam.

Aesthetic Rehabilitation with Nano- Ceramic Composite Material - Case Reports

@#Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of treatment, patient’s expectations and duration of treatment should be taken into consideration. This article presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with satisfactory outcome that mimic the natural dentition.

Comparison of the marginal microleakage of three cavity restoration methods / 实用口腔医学杂志

Objective:To compare the marginal microleakage of class V cavity restored with composite resin by 3 different methods. Methods:Class Ⅴ cavity was prepared in 36 human third molars,the teeth were randomly divided into 3 groups(n =1 2)and were repaired with common Z350 resin,pre-heated Z350 resin and Z350 resin inlay,respectively.After thermal cycling for 500 times the teeth were immersed in fuchsin solution for 24 h.Then the samples were sectioned longitudinally and examined for leakage under stereomicroscope.Results:The microleakage of cavity restoration by pre-heated Z350 resin and Z350 resin inlay was significantly low-er than that of the direct restoration with Z350 resin(P≤0.05).No significant difference was found between the groups of pre-heated Z350 resin and Z350 resin inlay.Conclusion:Marginal microleakage of Z350 resin restoration can be decreased by preheating of the resin.

Nine-year clinical evaluation of composite resins in Class III restorations / Avaliação de nove anos de restaurações de classe III em resina composta

The aim of this study was to evaluate thenine-year clinical performance of Class III composite restorations using two microhybrid anterior composite resins [Magic™-Vigodent/(F) and Z100™-3M ESPE/(Z)]. Material and Methods: The study was a randomized controlled trial, following the splitmouth design. Seventy restorations were placed, thirty-five for each resin composite into 35 patients. The restorations were placed by one operator according to the manufacturers’ specifications. Two independent evaluators conducted the clinical evaluation using modified USPHS criteria. After nine years, 56 restorations (28F-28Z) were evaluated. Data were analyzed using Chi-square, Exact Fisherand McNemar tests (p < 0.05). Results: Nopost operative sensitivity, secondary caries and loss of anatomic form was observed after nine-years for both composites. There were no significant differences between the two composites tested at baseline and after nine-years. Significant differen ces for Z and Frestorations between baseline and nine-year with respect to color matching and for F regarding themarginal integrity were detected. Conclusion: The clinical performance of both materials was consideredacceptable after the 9-year evaluation...

Objetivo: O objetivo deste estudo foi avaliar após nove anos a performance clínica de restaurações de classe III em resina composta, utilizando-se duas resinas microhíbridas para dentes anteriores [Magic-Vigodent/(F) e Z100-3M ESPE/(Z)]. Material e Métodos: Trata-se de um estudo clínico controlado aleatório, o qual utilizou o desenho de boca dividida.Setenta restaurações foram realizadas em trinta e cinco pacientes, sendo trinta e cinco para cada resina composta. As restaurações foram realizadas por um único operador seguindo as especificações dos fabricantes. Dois avaliadores independentes avaliaram as restaurações utilizando-se o critério USPHS modificado. Após nove anos, 56 restaurações(38F – 28Z) foram avaliadas. Os dados foram analisados por meio dos testes Qui-quadrado, Exato de Fisher e McNemar (p < 0,05). Resultados: Não foram detectados sensibilidade pós-operatória, cárie secundária e perda de forma anatômica no período analisado para ambas resinas. Não houve diferenças entre o período inicial e de nove anos para as resinas testadas, exceto para Z e F foram em relação à a cor e para a integridade do material para F. Conclusão: O comportamento clínico das duas resinas testadas foi considerado adequado após nove anos de avaliação...

Fracture resistance of endodontically treated maxillary premolars restored by silorane-based composite with or without fiber or nano-ionomer

PURPOSE: This in vitro study investigated the fracture resistance of endodontically treated premolars restored using silorane- or methacrylate-based composite along with or without fiber or nano-ionomer base. MATERIALS AND METHODS: Ninety-six intact maxillary premolars were randomly divided into eight groups (n = 12). G1 (negative control) was the intact teeth. In Groups 2-8, root canal treatment with mesio-occlusodistal preparation was performed. G2 (positive control) was kept unrestored. The other groups were restored using composite resin as follows: G3, methacrylate-based composite (Z250); G4, methacrylate composite (Z250) with polyethylene fiber; G5 and G6, silorane-based composite (Filtek P90) without and with the fiber, respectively; G7 and G8, methacrylate- and silorane-based composite with nano-ionomer base, respectively. After aging period and thermocycling for 1000 cycles, fracture strength was tested and fracture patterns were inspected. The results were analyzed using ANOVA and Tukey HSD tests (alpha=0.05). RESULTS: Mean fracture resistance for the eight groups (in Newton) were G1: 1200 +/- 169a, G2: 360 +/- 93b, G3: 632 +/- 196c, G4: 692 +/- 195c, G5: 917 +/- 159d, G6: 1013 +/- 125ad, G7: 959 +/- 148d, G8: 947 +/- 105d (different superscript letters revealed significant difference among groups). Most of the fractures in all the groups were restorable, except Group 3. CONCLUSION: Silorane-based composite revealed significantly higher strength of the restored premolars compared to that of methacrylate one. Fiber insertion demonstrated no additional effect on the strength of both composite restorations; however, it increased the prevalence of restorable fracture of methacrylate-based composite restored teeth. Using nano-ionomer base under methacrylate-based composite had a positive effect on fracture resistance and pattern. Only fiber-reinforced silorane composite restoration resulted in a strength similar to that of the intact teeth.

The effect of clinical performance on the survival estimates of direct restorations

OBJECTIVES: In most retrospective studies, the clinical performance of restorations had not been considered in survival analysis. This study investigated the effect of including the clinically unacceptable cases according to modified United States Public Health Service (USPHS) criteria into the failed data on the survival analysis of direct restorations as to the longevity and prognostic variables. MATERIALS AND METHODS: Nine hundred and sixty-seven direct restorations were evaluated. The data of 204 retreated restorations were collected from the records, and clinical performance of 763 restorations in function was evaluated according to modified USPHS criteria by two observers. The longevity and prognostic variables of the restorations were compared with a factor of involving clinically unacceptable cases into the failures using Kaplan-Meier survival analysis and Cox proportional hazard model. RESULTS: The median survival times of amalgam, composite resin and glass ionomer were 11.8, 11.0 and 6.8 years, respectively. Glass ionomer showed significantly lower longevity than composite resin and amalgam. When clinically unacceptable restorations were included into the failure, the median survival times of them decreased to 8.9, 9.7 and 6.4 years, respectively. CONCLUSIONS: After considering the clinical performance, composite resin was the only material that showed a difference in the longevity (p < 0.05) and the significantly higher relative risk of student group than professor group disappeared in operator groups. Even in the design of retrospective study, clinical evaluation needs to be included.

Cuspal deflection of directly or indirectly restored teeth / Deflexão cuspídea de dentes restaurados direta ou indiretamente

Objective: The aim of this study was to evaluate the cuspal deflection of teeth restored directly and indirectly. Material and Methods: Forty sound maxillary premolar teeth were restored with composite and different base materials. Wide mesial-occlusal-distal cavity preparations were performed, with isthmus width of one third of the distance between the cuspal tips, 3 mm occlusal and a 5 mm interproximal preparation height. The teeth were divided into 4 groups (n = 10), according to the restoration type: G1) GIC-DCR (1 mm glass ionomer cement base and direct restoration using nanoparticulate composite); G2) FL-DCR (1 mm base of flowable composite resin and direct restoration using nanoparticulate composite); G3) GIC-ICR (1 mm glass ionomer cement base and indirect restoration using nanoparticulate composite GIC base); G4) FL-ICR (1 mm base of flowable composite resin and indirect restoration using nanoparticulate composite). The specimens were submitted to compressive load of 50 N on the buccal and lingual cusps, in a universal testing machine. The lingual cusp microstrain (με) measurements were executed by strain gauges. Results: The Kruskal-Wallis (5%) test was used and showed there were no significant differences among the microstrain values for the four study groups (G1 = 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusion: It could be concluded that the restorative techniques and the bases employed did not show any influences in cuspal deflection

Objetivo: O objetivo deste trabalho foi avaliar, por meio de medidores de tensão, a deflexão cuspídea sofrida por dentes restaurados, direta e indiretamente, com resinas compostas e diferentes materiais de base. Material e Métodos: Para o preparo dos corpos-de-prova (CP) foram utilizados 28 dentes pré-molares humanos íntegros, extraídos por razões ortodônticas que tiveram suas raízes embutidas em poliuretano de densidade semelhante a do osso e suas raízes recobertas por um espaçador visando simular o espaço referente ao ligamento periodontal. Na etapa seguinte os dentes receberam preparos cavitários do tipo mésio-ocluso-distais amplos e então restaurados direta e indiretamente com resina composta e dois diferentes materiais de base/forramento, resina flow e cimento de ionômero de vidro. Para a realização das medidas de deflexão das cúspides foram utilizados extensômetros lineares elétricos colados à face lingual de cada dente e submetidos a uma carga de 50 N aplicada por uma ponta romba de diâmetro de 3,0 mm, que promoveu compressão simultânea nas vertentes triturantes das cúspides vestibular e lingual, numa máquina universal de ensaios. Resultados: Foi realizado o teste de Kruskall-Wallis (5%) de significância e não foram encontradas diferenças estatísticamente significantes entre os grupos (G1 – 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusão: Pode-se concluir que o tipo de restauração bem como o tipo de base empregados nesse estudo não alteram a deflexão cuspídea dos dentes com restaurações amplas.

1 year follow-up study of direct and indirect composite restorations / 대한치과보존학회지

BACKGROUND: The purpose of the present study was to evaluate the direct and indirect composite restorations which had been placed for 1 year. METHODS: The composite restorations which had been placed between 1999. Mar and 1999, Dec was evaluated after 1 year. For direct restorations, Spectrum (Dentsply, USA) and Z100 (3M, USA) were used in the anterior teeth and Surefil (Dentsply, USA) were used. For class V restorations of anterior and posterior teeth, Spectrum was used. For indirect restorations, Targis/Vectris system (Vivadent/Ivoclar, Liechtenstein) was used. 2 examiners evaluated marginal quality, proximal contact, discoloration, presence of 2nd caries, loss of filling and hypersensitivity of restorations. The restorations was clinically evaluated by modified methods based on USPHS. RESULTS: 60 teeth were evaluated. 59 were clinically acceptable and 1 restoration which was placed in class v cavity in the posterior tooth was fallen out. In most cases, the restorations were clinically acceptable. For restorations which had been directly placed in the class II cavities, loose proximal contact was indicated as the main complaints. CONCLUSIONS: Most of Anterior and posterior restorations which bad been directly or indirectly placed for 1 year were clinically acceptable. For posterior teeth, loose proximal contact was indicated as the main problem in the directly placed Class II restorations. Long term clinical study is needed.