Three-year evaluation of different adhesion strategies in non-carious cervical lesion restorations: a randomized clinical trial

Abstract: Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

Efeitos de diferentes dentifrícios na permeabilidade e rugosidade de dentina erodida / Effect of different toothpastes on permeability and roughness of eroded dentin

O objetivo deste estudo foi avaliar a rugosidade, a obliteração dos túbulos dentinários e a permeabilidade da dentina erodida e escovada com diferentes dentifrícios. Noventa dentes bovinos foram seccionadas em blocos, sendo que em trinta a hemiface foi protegida com verniz ácido resistente e sessenta foram submetidos ao teste de permeabilidade. Os espécimes foram divididos de acordo com os dentifrícios: sem flúor (SF), com fluoreto de sódio (NaF) e com fluoreto de estanho (SnF2). Em seguida, os blocos foram submetidos a um protocolo erosivo-abrasivo por 5 dias. As análises de rugosidade superficial e obliteração dos túbulos dentinários (n=10) foram realizadas nas hemifaces controle e teste do mesmo espécime e a análise da permeabilidade (n=20) foi realizada novamente. Os dados foram submetidos aos testes de ANOVA a dois critérios medidas repetidas e pós teste de Tukey (p≤0,05). Os grupos NaF e SnF2 apresentaram maior rugosidade comparando-se ao SF. O grupo SF apresentou a maior quantidade de túbulos abertos quanto comparado aos demais. Não houve diferença significativa na permeabilidade pós-ciclagem entre os dentifrícios SF e NaF, contudo o dentifrício SnF2 apresentou maior permeabilidade comparando-se aos demais. Ambos os dentifrícios contendo flúor tiveram oclusão efetiva dos túbulos dentinários; contudo, os efeitos da presença de fluoreto de estanho na permeabilidade podem ser neutralizados pela abrasão deste dentifrício(AU)

The aim of this study was to evaluate the roughness, dentin tubule occlusion and permeability of eroded dentin brushed with different toothpastes. Ninety bovine teeth were sectioned in blocks. The hemiface of thirty specimens was protect with acid resistant varnish and sixty were submitted to permeability test. The specimens were divided according to the dentifrices: without fluoride (WF), sodium fluoride (NaF) and stannous fluoride (SnF2). Then, the blocks were submitted to erosive-abrasive protocol for 5 days. The analysis of surface roughness and dentin tubule occlusion (n=10) were performed on control and test hemifaces of the same sample and permeability analysis (n=20) was again performed. Data were analyzed by two-way RM ANOVA and Tukey tests (p≤0.05). NaF and SnF2 groups presented higher roughness when compared with WF. WF group presented larger number of opened tubules compared to the others. No significant differences were found between WF and NaF for permeability; however, SnF2 presented higher hydraulic conductance compared to other dentifrices. In conclusion, both fluoride-containing toothpastes had promising tubule occlusion; however, the effects on permeability of stannous formulation may be counteracted by the effects of abrasion from this dentifrice(AU)

Influence of different types of light curing units and photoinitiators in microhardness and color of composite resins after immersion in wine / Influencia dos diferentes tipos de unidade fotoativadoras e fotoiniciadores na microdureza e cor de resinas compostas após imersão em vinho

Objective: the aim of this study is to evaluate the microhardness and color change (∆E) of composite resins, that were light-cured with different LEDs, after being immersed in a staining drink. Material and Methods: Two composite resins with Lucerin-TPO (Tetric N-Ceram/ Vit-l-escence) and camphorquinone (Filtek Z350) were selected. The specimens (n=120) were prepared and lightcured with LED of monowave or polywave lightemitting diode (LED) devices. Microhardness and color evaluations were measured before and after immersion in staining drink. Microhardness data were evaluated by Kruskal-Wallis test, MannWhitney and Wilcoxon tests. Color changes were evaluated by two-way analysis of variance (ANOVA) and Tukey test (p ≤ 0.05). Results: No statistically significant difference between the two generations of LEDs was found for microhardness data. Regarding the ∆E, a statistical difference between the two LEDs was observed for Tetric NCeram and Filtek Z350. Conclusion: The compostion of composites appears to have more influence on analyses than the type of LEDs used. A decreased microhardness occurred to Vit-lescence for monowave and to Filtek Z350 for both LED devices. A clinically perceptible color change was observed for Tetric-N Ceram and Filtek Z350 when polywave LED were used. (AU)

Objetivo: o objetivo deste estudo foi aviliar a microdureza e alteração de cor (∆E) de resinas compostas, fotoativadas com diferentes LEDs, imergidas em bebidas pigmetadas. Material e métodos: Duas resinas compostas com Lucerina-TPO (Tetric N-Ceram/ VIt-l-essence) e canforoquinona (Filtek Z350) foram selecionadas. Os espécimes (n=120) foram preparados. Os mesmos foram fotopolimerizados com LED monowave ou polywave. Microdureza e cor foram avaliadas antes e após a imersão em bebidas pigmentadas. Os dados de microdureza foram avaliados pelos testes de Kruskal-Wallis, Mann-Whitney e Wilcoxon. As alterações de cor foram avaliadas por análise de variância a dois critérios (ANOVA) e Tukey (p ≤ 0,05). Resultados: Não foi encontrada diferença estatística entre as duas gerações de LEDs, para os dados da microdureza. Quanto ao ∆E, foi encontrada diferença estatisticamente significante entre os dois LEDs, sendo observadas na Tetric N-Ceram na FIltek Z350. Conclusão: A composição das resinas compostas parece ter mais influencia nas análises do que o tipo de LEDs. Uma redução na microdureza ocorreu para Vit-lescence para monowave e para Filtek Z350 para ambos os dispositivos LED. Uma mudança de cor clinicamente perceptível foi observada em Tetric-N Ceram para polywave e Filtek Z350 para ambos os dispositivos LED. (AU)