Assessment of a conservative approach for restoration of extensively destroyed posterior teeth

Abstract Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. Objective This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. Methodology Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). Results Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. Conclusions Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

Biological restoration in permanent tooth: four-year follow-up / Restaurações biológicas em dentes permanentes: acompanhamento de 4 anos

Biological restorations, involving a technique of uniting autogenous or homogenous dental fragment for use as the primary restorative material, are an alternative for morphological and functional reestablishment of teeth with extensive coronal destruction. Despite the wide range of restorative materials available in dentistry, no material has proved to be as efficient as the natural tooth structure. This article illustrates a therapeutic option for rehabilitating a devitalized mandibular tooth with a weakened coronal remainder by using the biological restoration technique. The authors present the sequence of planning and performing the technique, such as the characteristics of preparation of the tooth and fragment, impression taking, cutting and cementation of the fragment, and the four-year follow-up of the biological restoration, which shows the success of the technique with marginal adaptation and satisfactory esthetic appearance. (AU)

As restaurações biológicas, envolvendo uma técnica de união de fragmentos dentários autógenos ou homogêneos como principal material restaurador, são uma alternativa para o restabelecimento morfológico e funcional de dentes com destruição coronal extensa. Apesar da ampla gama de materiais restauradores disponíveis na odontologia, nenhum material provou ser tão eficiente quanto a estrutura dentária natural. Este artigo ilustra uma opção terapêutica para reabilitar um molar inferior desvitalizado com um remanescente coronal fragilizado, utilizando a técnica de restauração biológica. Os autores apresentam a sequência de planejamento e execução da técnica, tais como as características de preparação do dente e do fragmento, moldagem, recorte e cimentação do fragmento, e o acompanhamento clínico de 3 anos da restauração biológica, mostrando o sucesso da técnica com uma adaptação marginal e aparência estética satisfatória (AU)

Displasia ectodérmica: relato de caso de reabilitação estético-funcional / Ectodermal dysplasia: case report of aesthetic and functional rehabilitation

Objetivo: Relatar o caso de reabilitação estéticoprotética de um paciente do gênero masculino com 6 anos de idade diagnosticado com Displasia Ectodérmica Hipohidrótica, atendido na clínica de pacientes especiais realizada no projeto de extensão da Universidade Federal Fluminense. Métodos: Trata-se de um estudo observacional, descritivo onde o tratamento restaurador e reabilitador foi realizado e retratado correspondendo às necessidades estéticas e funcionais do paciente. Resultados: Realizou-se reanatomização dos elementos 51 e 61 e confecção de prótese removível para suprir as ausências dos elementos 71, 72, 74, 81 e 82, propiciando função, estética e satisfação relatada pelo paciente. Conclusão: Este relato de caso contribuiu para o aumento de conhecimento acerca das formas de Displasia Ectodérmica, sobre a importância do diagnóstico diferencial das mesmas, bem como para o ensino dos alunos de graduação do projeto de extensão. (AU)

Objective: The aim of this study is to report a case of esthetic and prosthetic rehabilitation of a male 6-yearold patient diagnosed with Hypohidrotic Ectodermal Dysplasia, assisted at the clinicsfor individual withspecial needs held in the extension project of the Federal Fluminense University. Methods: This is a clinical, observational and descriptive study where the restorative and rehabilitative treatment was conducted and reported corresponding to the functional and esthetic needs of the patient. Results: The anatomical shape of teeth 51 and 61 was reconstructed and a partial removable prosthesis was made to cover the absence of teeth 71, 72, 74, 81 and 82, offering function, esthetics and satisfaction, as reported by the patient. Conclusion: This case contributed to increase the knowledge about the types of Ectodermal Dysplasia, the importance of differential diagnosis, as well as teaching of undergraduate students in the extension project. (AU)

Comparación de la microfiltración del Ketac™ Molar e Ionofil Molar® con centrix y espátula TRA / Comparison of the dental leakage between Ketac™ Molar e Ionofil Molar® with centrix and ART spatula

Introducción: El tratamiento restaurador atraumático, es utilizado como parte de los programas preventivos de salud pública, por ello es importante evaluar las técnicas de aplicación del material restaurador utilizando cemento ionómero de vidrio de autocurado. Objetivo: Comparar la microfiltración de los cementos ionoméricos Ketac™ Molar Easy Mix e Ionofil Molar® con dos técnicas de aplicación: jeringa centrix y espátula TRA. Materiales y métodos: Estudio experimental in vitro. Se utilizaron 52 dientes de bovino con preparaciones cavitarias. Las muestras se dividieron en 4 grupos según los cementos ionoméricos y según la técnica de aplicación. Se colocó el material restaurador siguiendo las indicaciones del fabricante. Todas las muestras fueron termocicladas, sumergidas en azul de metileno al 0,05% y seccionadas mediante un corte longitudinal. Se evaluó la microfiltración a través del software del esteromicroscopio. Para comparar las técnicas de aplicación según los cementos ionoméricos se utilizaron las pruebas estadísticas de t de Student y la prueba de U de Mann- Whitney. Resultados: La microfiltración de los cementos ionoméricos Ketac TM Molar Easy Mix e Ionofil Molar® según las técnicas de aplicación jeringa centrix y espátula TRA, no mostraron diferencias estadísticamente significativas (valor p>0,05). El cemento Ketac TM Molar Easy Mix y la técnica con la jeringa centrix y su respectiva combinación fueron los que presentaron menor microfiltración. Conclusión: Todos los dientes presentaron microfiltración y entre ellos el grupo KetacTM Molar Easy Mix® con la jeringa centrix mostraron menores valores de microfiltración

Introduction: Atraumatic restorative treatment is used as part of preventive public health programs, so it is important to evaluate the application techniques of restorative material. Objective: Compare the microleakage of the Ketac ™ Molar Easy Mix and Ionofil Molar® between two application techniques: Centrix syringe and spatula TRA. Materials and methods: Experimental in vitro study. 52 teeth of bovine with cavity preparations were used. The teeth were divided into 4 groups according to ionomer cements, also were subdivided, according to the technique. The restorative material was placed following the manufacturer’s instructions. All teeth were thermocycled, immersed in methylene blue 0.05% and sectioned. It was evaluated with an esteromicroscopio software. To compare the application techniques according the ionomer cements were used statistical tests: Student t test and Mann-Whitney U. Results: The microfiltration of Ketac ™ Molar Easy Mix and Ionofil Molar® ionomeric cements according to centrix syringe and TRA spatula application techniques showed no statistically significant differences (p value > 0.05). The Ketac TM Molar Easy Mix cement and the technique with the centrix syringe were those that presented less microfiltration. Conclusion: All teeth presented microfiltration and among them the group KetacTM Molar Easy Mix® with centrix syringe showed lower values of microfiltration.