Efecto del tratamiento de la morfología oclusal con materiales para restauraciones preventivas / Effect of treating occlusal morphology with materials for preventive restorations

Introducción: las fosas y fisuras son áreas formadas por delgadas irregularidades de la capa del esmalte de la superficie oclusal. La compleja morfología en dientes posteriores es un determinante biológico asociado al desarrollo de caries. Objetivo: evaluar el efecto de diversas formas de tratar la morfología oclusal en la adaptación y penetración de materiales utilizados en restauraciones preventivas. Material y métodos: diseño experimental e in vitro. Sesenta terceros molares fueron distribuidos aleatoriamente en dos grupos: surco sin ameloplastia y con ameloplastia; además, contaban con acondicionamiento del esmalte que se subdividió en tres subgrupos: 1) sellador de fosas y fisuras, 2) adhesivo/sellador de fosas y fisuras y 3) adhesivo/ resina Flow. Resultados: los subgrupos adhesivo/sellador y adhesivo/ Flow alcanzaron mayores valores de adaptación íntima a las paredes del surco. Las diferencias fueron significativas entre los materiales (p = 0.0009). Las mayores zonas de desadaptación resultaron para el sellador sin y con ameloplastia. La penetración de los materiales fue mayor en los surcos con ameloplastia. En los surcos tratados con ameloplastia, el adhesivo/Flow reveló el mayor porcentaje de penetración y la mejor adaptación a las paredes del surco. Conclusiones: la penetración del material está positivamente correlacionada con la profundidad del surco. El sellador con y sin ameloplastia mostró pobre adaptación a las paredes del surco (AU)

Introduction: pits and fissures are areas formed by fine irregularities in the enamel layer of the occlusal surface. The complex morphology in posterior teeth are biological determinants associated with the development of caries. Objective: to evaluate the effect of various ways of treating occlusal morphology on the adaptation and penetration of materials used in preventive restorations. Material and methods: experimental design, in vitro. Sixty third molars were randomly distributed into two groups: groove without ameloplasty and with ameloplasty, with enamel conditioning with three subgroups: 1) pit and fissure sealer, 2) adhesive/pit and fissure sealer, 3) adhesive/resin flow. Results: the adhesive/sealant and adhesive/flow subgroups reached higher values of intimate adaptation to the furrow walls. The differences were significant between the materials (p = 0.0009). The largest areas of maladjustment were found for the sealant without and with ameloplasty. The penetration of the materials was greater in the grooves with ameloplasty. In the grooves treated with ameloplasty, the adhesive/flow revealed the highest percentage of penetration and the best adaptation to the walls of the groove. Conclusions: the penetration of the material is positively correlated with the depth of the furrow. The sealant with and without ameloplasty showed poor adaptation to the sulcus walls (AU)

Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review

ABSTRACT Objective: To find out what the acid-base resistant zone (ABRZ) is and the mechanism of its formation. Material and Methods: This systematic review was based on the search of laboratory studies in which selfetching adhesive systems were used. The electronic database PubMed was used for the search. The search began on August 2021 and ended on June 2022. We have analyzed the materials and methods of each research and entered them in the appropriate tables to give a clearer assessment of the obtained results. Results: This systematic review included 15 full-text articles published from 2011 to 2019. The ABRZ is formed on both dentine and enamel. On dentine, the ABRZ is formed only when using self-etching adhesive systems; on the enamel, on the contrary, the step of preliminary etch and rinse contributes to the formation of a thicker ABRZ. The functional monomer MDP and fluorine increase the thickness of the ABRZ and provide a hybrid layer /ABRZ boundary without defects and erosions. Conclusion: Self-etching adhesive systems ensure the creation of an ABRZ resistant to acid-base tests. This phenomenon can provide the resistance of tooth tissues to demineralization, and therefore increase their resistance to caries.

Uso de adhesivo universal con pregrabado y autograbado en tejidos duros del diente / Use of universal adhesive with pre-etch and self etch strategies on hard tooth tissues

RESUMEN Introducción: Buscando satisfacer la demanda con procedimientos adhesivos más rápidos, menos sensibles a la técnica y facilidad de uso, se han desarrollado los adhesivos universales, que brindan al profesional la opción de seleccionar la estrategia de adhesión con diferentes modos de grabado, ya sea con grabado y enjuague, autograbado o grabado selectivo. Debido a la poca información existente, se han generado dudas sobre el rendimiento, propiedades y la aplicación de una técnica adhesiva adecuada sobre los tejidos dentales. Objetivo: Determinar el nivel de adhesión con el uso de adhesivos universales en modo de grabado y enjuague y autograbado. Métodos: Se realizó una revisión de la literatura, a través de la búsqueda electrónica en las bases de datos: SciELO, Scopus, PubMed, Springer y EBSCO. Inicialmente se seleccionaron por título y resumen, artículos duplicados se consideraron solo una vez, se incluyeron artículos de acceso libre y pagos, escritos en idioma español e inglés, publicados desde el año 2015, de los cuales 39 artículos fueron seleccionados para el estudio. Conclusiones: El uso de adhesivos universales sobre dentina presenta un nivel de adhesión mayor cuando se aplica en modo de autograbado. La aplicación activa del adhesivo universal en esmalte mejora la fuerza y resistencia de unión. El nivel de adhesión en el esmalte es mayor cuando se aplica en modo de grabado y enjuague. La resistencia inicial y por fatiga del adhesivo, no mejora con los tiempos prolongados del grabado ácido.

ABSTRACT Introduction: universal adhesives have been developed to satisfy the demand with faster adhesive procedures, less sensitive to the technique and ease of use, which offer the professional the option of selecting the adhesion strategy with different etching modes, either with etch-and-rinse, self-etch or selective etching ones. Doubts have been generated about the performance, properties and application of an adequate adhesive technique on dental tissues due to the little existing information. Objective: to determine the level of adhesion with the use of universal adhesives in etch-and-rinse and self-etch modes Methods: an electronic search of the literature was carried out in SciELO, Scopus, PubMed, Springer and EBSCO databases. Initially, articles were selected by title and abstract, duplicate ones were considered only once, free and paid access articles, written in Spanish and English and published since 2015 were included; 39 of them were selected for the study. Conclusions: the use of universal adhesives on dentin presents a higher level of adhesion when applied in self-etch mode. The active application of the universal adhesive improves the enamel bond strength. The level of adhesion on the enamel is higher when applied in etch-and-rinse. The initial fatigue resistance of the adhesive does not improve with prolonged acid etching times.

Uso efectivo de los adhesivos de octava generación / Effective use of eighth generation adhesives

Introducción: se realizó una revisión bibliográfica con el objetivo de conocer, analizar y comparar los diferentes tipos de adhesivos de octava generación que se encuentran en el mercado y la diferencia que existe entre cada uno. Los adhesivos universales han demostrado mejoras en su resistencia, sobre todo en las técnicas de aplicación y en las propiedades de estos materiales, al mejorar la fuerza adhesiva para que el odontólogo pueda brindar tratamientos restaurativos exitosos. Objetivo: conocer, analizar y comparar los diferentes tipos de adhe- sivos de la octava generación empleados en odontología. Material y métodos: se realizó una búsqueda en las bases de datos electrónicas PubMed, BVS, Redalyc y ScienceDirect. Se utilizaron 32 artículos que cumplieron con los criterios predeterminados y la especificidad reque- rida para la pregunta de investigación. Conclusiones: se demostró que la tecnología cada día avanza, sobre todo en el área de los adhesivos, ya que éstos son de mucha utilidad en el día a día del odontólogo; es importante conocer cada uno de éstos, puesto que es un poco complejo seleccionar el correcto, mas no el uso. En la actualidad, existen diversas opciones por las que el odontólogo puede optar, es por ello que el pro- fesional debe estar capacitado sobre cada una de las diferentes marcas existentes y, de acuerdo al tratamiento, debe elegir cuál es mejor utilizar en una rehabilitación. Es importante para el odontólogo conocer estos materiales, ya que esto lo beneficiará al momento de llevar un plan de tratamiento restaurador (AU)

Introduction: a bibliographic review was carried out to learn about, analyze, and compare the different types of eighth-generation adhesives on the market and the difference between each one. Universal adhesives have demonstrated improvements in their resistance, especially in the application techniques and properties of these materials, improving the adhesive strength so that the dentist can provide successful restorative treatments. Objective: to know, analyze and compare the different types of eighth-generation adhesives used in dentistry. Material and methods: a search was made of the following electronic databases: PubMed, BVS, Redalyc, ScienceDirect. Finally, 32 articles that met the predetermined criteria and the specificity required for the research question were used. Conclusions: it was demonstrated that technology is advancing every day, especially in the area of adhesives since these are very useful in the daily life of the dentist. It is important to know each one of these since it is a little complex at the moment of selecting the correct one, but not the use. Currently, there are several options that the dentist can choose, which is why the professional must be trained on each of the various existing brands and according to the treatment which is the best to use at the time of rehabilitation. The dentist needs to know these materials since they will benefit him/her when carrying out a restorative treatment plan (AU)

Comparación de la fuerza de adhesión a dentina de cementos de autograbado vs grabado total / Comparison of bond strength to dentin of self-etching cements vs total etching

Los sistemas cementantes han mejorado notablemente, los objetivos que persiguen los nuevos cementos es que la adhesión sea duradera y conseguir siempre que sea posible una interface cerrada con un sellado perfecto. Se han podido desarrollar nuevas técnicas y nuevos materiales de cementación que han ido perfeccionando la unión del material restaurador al diente. En el presente estudio se compara la fuerza de adhesión a dentina de cementos de autograbado y cementos de grabado total para comprobar los efectos positivos en el grabado de la dentina. Para el estudio se utilizaron dos cementos a base de resina (RelyX U200 Clicker 3M y RelyX Ultimate 3M). Se encapsularon 40 molares en acrílico en dos grupos de 20 muestras para la aplicación de dos sistemas cementantes de autograbado (grupo 1) y de grabado total (grupo 2), respectivamente, se desgastaron hasta descubrir la dentina; siguiendo las especificaciones del fabricante se colocó el cemento en cada grupo, y después se sometieron a pruebas de cizalla en una máquina de ensayo universal Instron. La medida expresada en megapascales (MPa) fue: grupo 1 = 7.5569 y grupo 2 = 12.6444. En este caso fueron analizados dos grupos, tomándose la primera significancia bilateral. Se realiza la prueba en t de Student, con 95% de intervalo de confianza en la diferencia, demostrando así que el cemento RelyX Ultimate 3M tiene mayor fuerza de adhesión que el cemento RelyX U200 Clicker 3M. Nuestra investigación fue factible y llegamos a nuestro propósito, en el cual comprobamos la mayor adhesión de cementos de grabado total, los cuales son sometidos a un previo tratamiento del diente (AU)

Adhesión a dentina parte I: características del sustrato y sistemas adhesivos / Dentin bonding part I: substrate characteristics and bonding systems

La Odontología Restauradora contemporánea no puede concebirse sin la adhesión de los materiales restauradores a las estructuras dentarias. En mu-chos procedimientos restauradores, no sólo el esmal-te sino también la dentina se encuentra involucrada, por lo tanto, la adhesión a esta última juega un rol cla-ve en el éxito clínico. No obstante, todavía supone un gran desafío lograr una adhesión estable y predeci-ble en el tiempo. El propósito del presente artículo es analizar las características principales de la dentina como sustrato adhesivo y describir los sistemas ad-hesivos actuales y sus mecanismos de acción (AU)

Contemporary Restorative Dentistry cannot be conceived without the adhesion of restorative materials to dental structures. In many restorative procedures not only the enamel, but also the dentin is involved, therefore dentin bonding plays a key role in their success. However, it is still a great challenge to achieve stable and predictable dentin bonding over time. The aim of this article is to analyze the main characteristics of dentin as an adhesive substrate and to describe current adhesive systems and their bonding mechanisms (AU)

Adhesión a dentina part II: estrategias para optimizar la adhesión a dentina y protocolos adhesivos / Dentin bonding part II: strategies to optimize dentin bonding and adhesive protocols

La adhesión a dentina con sistemas adhesivos polimé-ricos representa un desafío que surge de la necesi-dad de vincular un sustrato dentario heterogéneo y variable con materiales que presentan todavía cier-tos aspectos a atender para poder conseguir el máxi-mo desempeño. El propósito del presente artículo es evaluar algunas de las estrategias propuestas para mejorar la adhesión a dentina, y sugerir un protocolo de trabajo con los diferentes tipos de sistemas adhesivos (AU)

Dentin bonding with polymeric adhesive systems represents a challenge that arises from the need to link a heterogeneous and variable dental substrate with materials that still have certain aspects to be addressed in order to achieve maximum performance. The aim of this article is to evaluate some of the proposed strategies to improve dentin bonding and to suggest a protocol for each different type of bonding systems (AU)

Tratamiento de la fractura corono-radicular no complicada de la corona: caso clínico / Treatment of non-complicated crown-root fracture: a clinical case

El trauma dentoalveolar se define como aquella lesión de extensión e intensidad variable y de ori- gen accidental o intencional, causada por fuerzas que actúan sobre el órgano dentario y los tejidos que lo rodean. Se puede diagnosticar a simple vista o con ayuda de la radiografía, se debe tratar sin demora para preservar la vitalidad de la pulpa, sobre todo en casos de niños y adolescentes, to- mando en cuenta la formación radicular. El trau- ma dental es motivo de urgencia por el dolor que provocan en los pacientes, la prevalencia varia del 26 al 76% de las lesiones dentales en dentición permanente (AU)

Caracterización microscópica de la dentina de dientes temporales / Microscopic characterization of the dentin of temporary teeth

La dentina se compone de un mineral de fosfato de calcio identificado como dahllita, que se dispone en pequeños cristales de hidroxiapatita carbonatada con dimensiones de 36 × 25 × 4 nm, y por una fase orgánica cuyo principal componente es el colágeno tipo 1 en 90%, que se orienta en forma de malla. Esta conformación corresponde a los dientes permanentes. Dentro de las estructuras, encontramos túbulos dentinarios que miden, aproximadamente, entre 0.5-1 µm de diámetro en la periferia y hasta 3-5 µm cerca de la pulpa. En el presente estudio, realizado en dentina de dientes temporales, el lumen de dichos túbulos es más grande cuando se encuentra cerca de la pulpa dental. Asimismo, se encontraron cambios elementales importantes de acuerdo con las diferentes profundidades en las que se observó, encontrando un aumento en el peso porcentual de carbono cuando se encuentra a mayor profundidad, lo que indica una composición orgánica mayor en la dentina pulpar. En estudios de dientes permanentes esta composición es disminuida y con mayor concentración en la dentina cercana a la unión amelodentinaria. En dentina de dientes temporales se encontraron diferencias en el recuento de túbulos dentinarios por mm2, comparado a la dentina de dientes permanentes, donde el número de túbulos no varía mucho (AU)

Dentin is composed of a calcium phosphate mineral identified as dahllite, which is arranged in small crystals of carbonated hydroxyapatite with dimensions of 36 × 25 × 4 nm, and by an organic phase whose main component is type l collagen in 90%, which is oriented in the form of a mesh. This conformation corresponds to permanent teeth. Within the structures, we find dentin tubules that measure approximately 0.5-1 µm in diameter at the periphery and up to 3-5 µm near the pulp. In the present study, carried out in dentin of primary teeth, the lumen of these tubules is larger when it is close to the dental pulp. Likewise, important elemental changes were found according to the different depths in which it was observed, finding an increase in the percentage weight of carbon when it is at a greater depth, indicating a greater organic composition in the pulp dentin. In studies of permanent teeth, this composition is decreased and with a higher concentration in the dentin near the amelodentinal junction. In dentin of primary teeth, differences were found in the count of dentin tubules per mm2, compared to dentin of permanent teeth, where the number of tubules did not vary much (AU)

Influence of laser deproteinization of acid-etched dentin on marginal microleakage of class V composite restoration

Aim: Recent reports indicate that deproteinization of acid-etched dentin surface can extend penetration depth of adhesive agents. The main goal of the present research was to investigate the deproteinization effect of Nd:YAG and diode 940 lasers on acid-etched dentin and microleakage grade in class V composite restorations. Methods: 36 extracted human premolar teeth were selected to make standard buccal and lingual class V cavities. These samples were randomly split into three sub-groups: 1.Control group, in which composite was applied for restoration after etch and bonding process without deproteinization; 2.Nd:YAG laser group, in which the teeth were deproteinized with Nd:YAG laser after etching and painting internal surfaces of cavities with Van Geison stain and then composite restorations applied just as control group; 3.Diode laser group, in which the process was similar to Nd:YAG laser group, but instead, diode 940 laser was irradiated. The teeth were bisected into two equal longitudinal buccal and lingual halves. Marginal microleakage of samples was scored by using a stereomicroscope. Kruskal- Wallis, Mann-Whitney U and Fisher's statistical tests were employed for analysis of the obtained data. Results: A significant reduction in marginal microleakage was observed for both groups treated with laser (Nd:YAG and diode 940)compared to control (p=0.001 & p=0.047). There was no significant difference in marginal microleakage between Nd:YAG laser and diode 940groups (P = 0.333). Conclusion: Nd:YAG and diode 940 laser deproteinization of acid-etched dentin decreased the marginal microleakage of in-vitro class V resin composite restorations

Sistemas adesivos universais ­ há 10 anos no Brasil: revisão de literatura / Universal adhesive systems ­ 10 years in Brasil: literature review

Objetivo: analisar, a partir da literatura publicada, os sistemas adesivos universais, conceituando sobre seu desempenho nos diferentes substratos, assim como potenciais estudos executados com eles após 10 anos no Brasil. Materiais e métodos: para esta revisão narrativa, foram pesquisados artigos na língua inglesa nas bases de dados eletrônicas PubMed/Medline, SciELO e Scopus, publicados de 2012 a 2022, período considerado por ser a última década, além dos 10 anos da chegada do sistema adesivo universal ao Brasil. Utilizaram-se os seguintes descritores: universal adhesives (adesivos universais) OR universal adhesive system (sistemas adesivos universais). Realizou-se a inclusão de estudos laboratoriais (in vitro), ensaios clínicos, revisões de literatura e sistemáticas com meta-análise. Resultados: após análise meticulosa, foram selecionados 56 estudos. Os adesivos universais são considerados mais "amigáveis" ao usuário, pois permitem ao clínico a utilização no modo condicione e lave e autocondicionante, principalmente devido à inclusão do monômero MDP ou de monômeros similares. No esmalte, o condicionamento ácido seletivo antes da aplicação do adesivo é recomendado. Permite ser utilizado com uma diversidade de substratos, a aplicação de forma ativa do adesivo melhora a resistência de união. Conclusão: os sistemas adesivos universais foram lançados para tornar os procedimentos de adesão mais simples. Entretanto, mais ensaios clínicos com maiores tempos de acompanhamento são necessários, para avaliar adequadamente a efetividade desse material.(AU)

Objective: To evaluate, from published literature, the universal adhesive systems, conceptualizing their performance, as well as potential studies performed using this material. MATERIAL AND METHODS: This narrative review considered articles in the English language searched on Pubmed/ Medline, Scielo and Scopus from 2012 to 2022, considered period to be the last decade, besides ten years of the universal adhesive system arrived in Brazil. The descriptors "universal adhesive" or "universal adhesive systems" were used. Laboratorial studies (in vitro), clinical trials, literature review and systematic review with meta-analysis were included. RESULTS: 56 studies were included. The universal adhesives are considered more user-friendly, allowing for etch & rinse and self-etch modes, mostly due to MDP monomer or similar monomers inclusion. In enamel selective acid etching before adhesive application is recommended. The system can be used with great amount of substrates and results in superior bond strength when applied through active mode. CONCLUSION: Universal adhesive systems were launched to simplify the adhesion procedure, however more clinical trials with longer follow-ups are required using this material, with adequate evaluation of their effectiveness.(AU)

Eficacia del cementado indirecto / Indirect bonding efficiency

La aparición de aparatología preadjustada ha colaborado en la efectividad de los tratamientos de ortodoncia, pero para que la expresión de esta aparatología se logre, es necesario una correcta colocación de los brackets y la permanencia de estos en boca durante todo el tratamiento. La precisión en la colocación mejora con la técnica de cementado indirecta, ya que permite el acceso a las zonas posteriores, a lugares donde se ve disminuida la visión y además disminuye la condensación de aliento y contaminación salival. Si bien esta técnica requiere tiempo extra de laboratorio, es más rápida en la etapa clínica (AU)

Contaminación de la dentina con diferentes técnicas de secado / Contamination of dentin with different drying techniques

El secado es uno de los factores clave para lograr una adhesión micromecánica exitosa en la dentina con los sistemas adhesivos de grabado independiente. El objetivo de este trabajo fue comparar los residuos remanentes luego de cuatro procedimientos diferentes de secado en preparaciones ex vivo en dentina. Se utilizaron cinco terceros molares ex-vivo, en cada uno de los cuales se realizó una preparación dentinaria en piso y paredes con al menos un socavado. Las unidades experimentales fueron almacenadas en solución fisiológica durante 7 días. Las distintas técnicas de secado (G1- G8) se aplicaron, luego de que las preparaciones fueron tratadas con gel de ácido fosfórico al 37% (Blue Gel etch Megadental) durante 15s y lavadas con jeringa y agua a presión durante 15s (Técnica de Grabado Ácido o TGA), de la siguiente manera: algodón común (Condesa) (G1), papel tisú (Achiss) cortado a mano (G2) y con tijera (G3), esponja (Sharpys) (G4), papel tisú (Simplicity) cortado a mano (G5)(AU)

Effect of surface treatments on the adhesive properties of metallic brackets on fluorotic enamel

ABSTRACT Objective: To compare the effectiveness of the pretreatment with sandblasting and deproteinization with NaOCl on bond strength (SBS), in situ conversion degree (CD) of brackets in fluorotic enamel, and enamel etching pattern. Methods: A total of 90 non-carious maxillary premolars were used. The teeth were then assigned to six experimental groups according to: enamel surface (sound and fluorotic enamel); surface treatment (Regular etch with 37% phosphoric acid [RE]; 5.2% sodium hypochlorite + phosphoric acid [NaOCl + RE]; sandblasting + phosphoric acid [sandblasting + RE]). After storage in distilled water (37°C/24h), the specimens were tested at 1 mm/min until failure (SBS). Enamel-resin cement interfaces were evaluated for CD using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a scanning electron microscope. Data from SBS and in situ CD values were analyzed using ANOVA two-away and Tukey test (α=0.05). The enamel etching pattern was evaluated only qualitatively. Results: For sound enamel, RE showed the highest SBS values, when compared to NaOCl + RE and Sandblasting + RE groups (p< 0.01). Regarding CD, only NaOCl + RE significantly compromised the mean DC, in comparison with other groups (p= 0.002). For fluorotic enamel, the Sandblasting + RE group significantly increased the mean SBS values, in comparison with RE group (p= 0.01) and no significant change was observed for CD (p> 0.52). Conclusions: The application of NaOCl or sandblasting associated to phosphoric acid improved the SBS of the brackets in fluorotic enamel without compromising the CD of the resin cement, with improving of enamel interprismatic conditioning.

RESUMO Objetivo: Comparar a efetividade do pré-tratamento com jateamento e desproteinização com NaOCl na resistência de união (SBS), grau de conversão in situ (GC) dos braquetes metálicos ao esmalte fluorótico e o padrão de condicionamento do esmalte. Métodos: Foi utilizado um total de 90 pré-molares superiores livres de cárie. Os dentes foram divididos em seis grupos experimentais, de acordo com: superfície do esmalte (Esmalte Sadio e Fluorótico); tratamento de superfície (Condicionamento com ácido fosfórico a 37% [ER]; Hipoclorito de sódio a 5,2% + ácido fosfórico [NaOCl + ER]; e jateamento + ácido fosfórico [Jateamento + ER]). Após armazenamento em água destilada (37oC/24 h), os espécimes foram testados a 1 mm/min até a falha (SBS). As interfaces esmalte-cimento foram avaliadas para GC usando espectroscopia micro-Raman. O padrão do condicionamento do esmalte foi avaliado sob microscopia eletrônica de varredura. Os dados da SBS e GC foram analisados utilizando ANOVA dois fatores e teste de Tukey (α= 0,05). O padrão de condicionamento do esmalte foi avaliado apenas qualitativamente. Resultados: Para o esmalte sadio, o ER apresentou os maiores valores de SBS, quando comparado aos grupos NaOCl + ER e Jateamento + ER (p< 0,01). Em relação ao GC, apenas a média do grupo NaOCl + ER foi comprometida significativamente em comparação aos outros grupos (p= 0,002). Para o esmalte fluorótico, Jateamento + ER aumentou significativamente a média dos valores de SBS, em comparação com o grupo ER (p= 0,01) e nenhuma mudança significativa foi observada no GC (p> 0,52). Conclusões: A aplicação de NaOCl ou jateamento associado ao ácido fosfórico melhorou a SBS dos braquetes no esmalte fluorótico sem comprometer o GC do cimento resinoso, com a melhoria do condicionamento interprismático do esmalte.

Evaluación de la adhesión de sistemas adhesivos de grabado total en esmalte dental bovino usando un agente desproteinizante: un estudio in vitro / Evaluation of adhesion of total etch adhesive systems on bovine dental enamel using a deproteinizing agent: an in vitro study

Introducción: Hoy en día, la mayoría de los pacientes requieren tratamiento de ortodoncia fija convencional, la cual utiliza procedimientos adhesivos afines con la superficie amelodentinaria. Aunque existen diferentes técnicas adhesivas que pueden ofrecer adecuados niveles de resistencia al desalojo, el uso del hipoclorito de sodio (NaClO) como agente desproteinizante no ha sido bien definido en materiales de cementación en aparatología ortodóncica convencional. Objetivo: El objetivo de este estudio fue determinar los niveles de resistencia al desalojo con pruebas de microtensión y análisis topográfico con microscopia electrónica de barrido. Material y métodos: 20 bloques de esmalte bovino fueron expuestos superficialmente a soluciones acondicionadoras (ácido ortofosfórico al 37%) con y sin agente desproteinizante (NaClO al 5.25%); finalmente, brackets individuales de ortodoncia fueron cementados con sistemas adhesivos y resinas compuestas de casas comerciales (Ormco y 3M). Las pruebas de resistencia al desalojo fueron realizadas con una máquina de fuerzas universales y el análisis topográfico con microscopia electrónica de barrido. Resultados: El uso del NaClO al 5.25% y la marca Ormco tuvieron estadísticamente los mejores niveles de adhesión que el grupo sin desproteinización y la casa comercial 3M, respectivamente. La topografía adamantina expuesta al agente desproteinizante mostró características de superficie relacionadas con el patrón de grabado tipo I. Conclusión: El uso de un agente desproteinizante (NaClO 5.25%) así como una marca comercial (Ormco) en particular podrían definir el aumento en los niveles de adhesión en superficies adamantinas con aparatología ortodóncica convencional (AU)

Introduction: Nowadays, patients require conventional fixed orthodontic treatment, which uses adhesive procedures related to the dentinal denture surface. Although there are different adhesive techniques that can offer adequate levels of bonding resistance, the use of NaClO as a deproteinizing agent has not been well defined in cementing materials in conventional orthodontic appliances. Objective: The objective of this study was to determine the levels of bond resistance using micro tension tests and topographic analysis with scanning electron microscopy. Material and methods: Twenty-blocks of bovine enamel were exposed superficially to conditioning solutions (37% orthophosphoric acid) with and without deproteinizing agent (5.25% NaClO); finally, individual orthodontic brackets were cemented with adhesive systems and resin composites of different trademarks (Ormco and 3M). Bonding resistance tests were performed with a universal force machine and topographic analysis was made with scanning electron microscopy. Results: The use of 5.25% NaClO and the Ormco brand had statistically better levels of adhesion than the group without deproteinization and the 3M brand, respectively. Adamantine topography exposed to the deproteinizing agent showed surface characteristics related to the type I etching pattern. Conclusion: The use of a deproteinizing agent (NaClO 5.25%) as well as a trademark (Ormco) in particular conditions could define the increase in adhesion levels on adamantine surfaces with conventional orthodontic appliances (AU)

Agentes condicionantes alternativos no procedimento adesivo: revisão de literatura / Alternative conditioning agents in the adhesive procedure: literature review

Objetivos: revisar a literatura acerca do uso de ACA no procedimento adesivo. Métodos: Realizaram-se duas buscas distintas na literatura, na base de dados PubMed, na qual a primeira se utilizou das palavras-chave "Restorative dentistry" e "Alternativeconditioning", combinadas entre si pelo operador booleno "AND". Encontraram-se 28 estudos sem restrição de período em que, após a leitura crítica de títulos e resumos, selecionaram-se três. A segunda busca utilizou as palavras-chave "Alternativeconditioning", "Adhesives" e "Dentistry", combinadas pelo operador booleano "AND", encontrando 72 estudos sem restrição de período e, após a leitura de títulos e resumos, selecionaram-se três. Entre eles, o Ácido Fosfórico (AF) foi incapaz de remover a camada hipermineralizada de dentina das Lesões Cervicais Não Cariosas (LCNC). Resultados: Notou-se a eficácia do EDTA, como alternativa ao condicionamento convencional, nas superfícies tratadas com clorexidina. Já o ácido metafosfórico a 40% dispôs de precipitação do mineral bruxita. O condicionamento com Ácido Cítrico (AC) a 5% e Cloreto Férrico Anidro (CFA) a 0,6% e 1,8%, ambos exibiram ótima microtração. O condicionamento com Ácido Nítrico (AN) a 10% e Oxalato Férrico (OF) a 3% reduziu a resistência de união. Entretanto, o resultado pode variar conforme o adesivo utilizado. Conclusão: Os estudos comprovaram a eficácia da aplicação de ACA em procedimentos adesivos, contribuindo com o aumento da retenção das restaurações.

Objective: The Alternative Conditioning Agents (ACA) aim to reduce the biodegradation of adhesive interfaces in resinous restorations. Methods: The aim was to review the literature on the use of ACA in the adhesive procedure. Two different searches were performed in the literature, in the PubMed database, in which the first one used the keywords "Restorative dentistry" and "Alternative conditioning", combined with the Boolene operator "AND". There were 28 studies without period restrictions in which, after critical reading of titles and abstracts, 3 were selected. The second search used the keywords "Alternative conditioning", "Adhesives" and "Dentistry", combined by the Boolean operator "AND", finding 72 studies without period restriction and, after reading titles and abstracts, 3 were selected. Among these, phosphoric acid (PA) was unable to remove the hypermineralized dentin layer from non-carious cervical lesions (NCCL). Results: The efficacy of EDTA, as an alternative to conventional conditioning, was noted on surfaces treated with chlorhexidine. Metaphosphoric acid at 40% had precipitation of the "bruxita" bauxite/brucite mineral. The conditioning with 5% Citric Acid (CA) and 0.6% and 1.8% Anhydrous Ferric Chloride (AFC) both showed excellent microtraction. Citric Acid (CA) conditioning at 10% and Ferric Oxalate (FO) at 3% reduced the bond strength. However, the result may vary according to the adhesive used. Conclusion: Studies have proven the efficacy of ACA in adhesive procedures, contributing to increased retention of restorations.

Influência do Condicionamento Ácido na Resistência de União entre Cerâmica Feldspática e Cimento Resinoso / Influence of Acid Etching on Bond Strength Between Feldspathic Ceramics and Resin Cement

Objetivo: Analisar a influência da resistência de união entre cimento resinoso e cerâmica feldspática utilizando concentrações e tempos de aplicação diferentes de acído fluorídrico (HF). Material e Métodos: Foram confeccionados 18 discos de cerâmica feldspática (Ø10mm - 2mm de espessura) através da técnica incremental, que foram incluídos em resina acrílica e regularizados com lixas de carbeto de silício com granulações de 600, 1200 e 2000 através de uma máquina de polimento com velocidade de 600 rpm para regularização. Logo após foram mergulhadas em água destilada durante 10 minutos em cuba ultrassônica. Todos corpos de prova foram condicionados com HF e silanizados. Foram confeccionados quatro cilindros de cimento sobre cada corpo de prova (n=12), feitos com cimento resinoso Relyx ARC. Logo após, dividiu-se em seis grupos de acordo com o protocolo de tratamento de superfície: G1 (5% - 40s); G2 (5% - 60s); G3 (5% - 80s); G4 (10% - 40s); G5 (10% - 60s) e G6 (10% - 80s). Os corpos de prova foram submetidos ao Teste de Microcisalhamento, com força vertical a uma velocidade de 0,5 mm/min sobre a peça. A resistência de união ao microcisalhamento foi calculada e expressa em Megapascal (MPa). Os dados foram submetidos à análise de variância (ANOVA) dois fatores e para comparações múltiplas foi utilizado o Teste de Tukey, sendo o nível de significância de 5%. Resultados: Quando analisado a concentração do HF, não houve diferenças estatísticas (p>0,05). Na comparação dos tempos de aplicação, G3 (5% - 80s) e G6 (10% - 80s) obtiveram maiores resultados de resistência ao microcisalhamento que os demais grupos. Conclusão: As diferentes concentrações de HF não influenciaram na resistência de união entre cerâmica feldspática e cimento resinoso. Já o aumento do tempo de condicionamento com HF afetou na resistência de união

Objective: analyze the influence of bond strength between resin cement and feldspathic ceramics using different concentrations and application times of hydrofluoric acid (HF). Materials and Methods: 18 feldspathic ceramic discs (Ø10mm - 2mm thickness) were made through the incremental technique, which were included in acrylic resin and regularized with silicon carbide sandpaper with granulations of 600, 1200 and 2000 through a polishing machine with a speed of 600 rpm. Soon after, they were immersed in distilled water for 10 minutes in an ultrasonic bath. All specimens were conditioned with HF and silanized. Four cement cylinders were made on each specimen (n=12), manufactured with Relyx ARC resin cement. After that, it was divided into six groups according to the surface treatment protocol: G1 (5% - 40s); G2 (5% - 60s); G3 (5% - 80s); G4 (10% - 40s); G5 (10% - 60s) e G6 (10% - 80s). The specimens were subjected to the Microshear Test, with vertical force at a speed of 0.5 mm min on the specimen. The microshear bond strength was calculated and expressed in Megapascal (MPa). The data were submitted to two-way analysis of variance (ANOVA) and Tukey's test for multiple comparisons, with a significance level of 5%. Results: when the concentration of HF was analyzed, there were no statistical differences (p>0.05). In the comparison of application times, G3 (5% - 80s) and G6 (10% - 80s) obtained higher results of microshear resistance than the other groups. Conclusion: The different concentrations of HF did not influence the bond strength between feldspathic ceramics and resin cement. However, the increase in the time of HF conditioning affected in the bond strength.

Effects of three self-etch adhesives and mild salivary contamination on the bonding durability of deciduous teeth / 北京大学学报(医学版)

OBJECTIVE@#To compare the bonding durability of three different self-etch adhesives to primary enamel and dentin, and to investigate the effect of mild salivary contamination followed by air drying on the bonding durability.@*METHODS@#Two hundred and forty enamel specimens were divided randomly into 16 groups (n=15/group)according to the adhesive system [self-etch adhesives: Clearfil SE Bond(SE), AdperTM Easy One (EO), Scotchbond Universal (SBU); total-etch adhesive: AdperTM Single Bond Plus(SL)], contamination status (non-contaminated vs. salivary-contaminated) and storage condition (stored in distilled water for 24 h vs. aging mode 5 000 thermal cycles in 5 ℃ and 55 ℃). Two hundred and forty dentin specimens were assigned in the same way. Shear bond strength for 12 specimens in each group were measured. The adhesive interface for the residual specimens in each group was observed by scanning electron microscopy(SEM). Data were analyzed by three-way analysis of variance and Tukey test(P < 0.05).@*RESULTS@#For primary enamel, total-etch adhesive showed higher initial shear bond strength values (28.92±1.83) MPa and shear bond strength values (27.27±3.03) MPa after thermal cycles compared with the other groups, and the difference between the groups was statistically significant (P < 0.01). Shear bond strength values of EO decreased significantly in salivary-treated groups, regardless of storage conditions, and the difference was statistically significant (P < 0.01). For primary dentin, shear bond strength values of EO decreased significantly in salivary-treated groups after 24 h (P < 0.01). After 5 000 thermal cycles, total-etch adhesive showed significantly lower shear bond strength values (14.31±1.97) MPa compared with the other groups, and the difference between the groups was statistically significant (P < 0.01), and shear bond strength values of EO were significantly lower than those in SE and SBU groups (P < 0.01), regardless of contamination status.@*CONCLUSION@#Total-etch adhesive SL has better bonding durability to primary enamel. SE and SBU have better bonding durability to primary dentin and have a certain resistance to salivary contamination, while the bonding performance of EO is compromised greatly by mild salivary contamination followed by air drying.

Evaluation of microtensile bond strength between resin composite and glass ceramic / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the microtensile bond strength of resin composite to glass ceramic, and the effect of surface treatment of resin composite and thermal cycling aging on the microtensile bond strength.@*METHODS@#Rectangular blocks were made with dentin of extracted molars, resin composite or feldspathic glass ceramic respectively. The bonding surfaces of these rectangular blocks were sanded by 600-grit silicon carbide paper before luting. A self-etching resin cement was used as luting agent. The specimens were divided into groups according to the types of substrates of adhesion (dentin/glass ceramic or resin composite/glass ceramic), the way of surface treatments and whether thermal cycling aging ocurred. The dentin blocks were adhered to ceramic blocks as controls (group A1 and A2). The resin composite blocks were adhered to the ceramic blocks as experiment groups. The resin composite surfaces were treated by different ways before luting: no extra surface treatment (group B1 and B2), treated by ethyl methacrylate solution (group C1 and C2) or silane coupling agent (group D1 and D2), coarsened by 360-grit silicon carbide paper (group E1 and E2) or polished by 1 200-grit silicon carbide paper (group F1 and F2). After luting, the microtensile bond strength of the specimens were tested before (group A1-F1) or after (group A2-F2) thermal cycling aging. After microtensile bond strength test, the fracture bonding surfaces of the specimens were observed by a scanning electron microscopy to determine the type of bonding failure. The data were statistically analyzed using one-way analysis of variance.@*RESULTS@#The microtensile bond strength of resin composite to glass ceramic with no extra treatment achieved high bond values before and after thermal cycling [B1 (30.02±3.85) MPa, B2 (26.83±3.14) MPa], which were statistically different from those of the control groups [A1 (20.55±4.51) MPa, A2 (12.94±0.69) MPa, P < 0.05]. The microtensile bond strength between the glass ceramic and resin composite did not increase after different surface treatments of resin composite.@*CONCLUSIONS@#The microtensile bond strength between resin composite and glass ceramic achieved as similar bond strength as that between dentin and glass ceramic and even better. Surface treatment of resin composite via methyl methacrylate solution, silane coupling agent, coarsening, or polishing did not increase the microtensile bond strength effectually.

Effects of various surface treatments on the bonding efficacy of noncarious cervical sclerotic lesions / 华西口腔医学杂志

Noncarious cervical sclerotic lesions (NCSL) are dental cervical lesions with noncarious sclerotic dentine (NCSD), which appears smooth, hard, and either light yellow or dark brown. Most NCSLs are wedge or dish shaped and commonly occur in canines and premolars, leading to dental hypersensitivity and aesthetic defect. The principal treatment is composite resin restoration; however, many clinical problems, such as retention loss, should not be ignored. NCSL's bonding interface includes NCSD and enamel, and interface pre-treatment can promote the bonding effect. This review summarizes current surface treatment methods and their influence on the bonding effectiveness of NCSL to provide guidance for clinical practice.