Evaluation of the fracture resistance of premolars with extensive and medium cavity preparations restored with direct restoring systems

Studies have been conducted to measure the fracture resistance of restored teeth with the current restorative materials. However, most of those studies disregard the cavity size as an influencing variable. Aims: To evaluate the fracture resistance of prepared and restored maxillary premolars with medium and large preparations. Materials and Methods: Seventy superior and sound premolars were randomly divided: G1 (control) – sound tooth; G2, G3, and G4 received a Class II mesial-occlusal-distal (MOD) preparation with an occlusal box width 1/3 of the intercuspal distance, and were restored with Filtek Z350 XT, IPS Empress Direct, and Charisma Diamond, respectively; G5, G6, and G7 received a Class II MOD preparation with an occlusal box width 2/3 of the intercuspal distance, and were restored with Filtek Z350 XT, IPS Empress Direct, and Charisma Diamond, respectively. After storage in water, at 37°C, the specimens were subjected to a fracture test under compression in a universal testing machine where the loads were applied vertically and at a speed of 0.5 mm/min. Statistical Analysis Used: Data were analyzed with two-way ANOVA and Tukey's multiple comparison post hoc test (P < 0.05). Results: G1 presented a fracture resistance significantly higher (P = 0.005) than any other experimental groups. Among the experimental groups, only G5 showed a significantly low fracture resistance (P = 0.019) when compared to the other groups. For the other resins, the change in intercuspal distance from 1/3 to 2/3 the intercuspal distance did not significantly reduce the fracture resistance (P > 0.05). Conclusions: The cavity preparation weakens the remaining tooth structure; however, its resistance could be partially restored using direct adhesive restorations.

Restauração Classe IV: estratificação natural com resina composta / Class IV restorations: natural stratification with composite resin

Restaurar apenas um dente anterior fraturado é um desafio para a Odontologia Estética, em função do restabelecimento da forma e da cor, necessárias para a reprodução fiel das características do dente natural. Este artigo apresenta algumas estratégias para facilitar o planejamento e a execução de uma restauração Classe IV no incisivo central superior com resina composta nanoparticulada, mediante o uso de um mapa cromático com a seleção das cores, seguido de um ensaio restaurador. Passados 5 dias, o ensaio foi avaliado e realizada a restauração definitiva. As etapas de acabamento, polimento e texturização foram conduzidas para mimetizar a estrutura dental...

Restoration of a single anterior fractured tooth is a challenge in aesthetic dentistry, since it is difficult to reestablish form and color, necessary for the accurate reproduction of the features present in natural teeth. This article presents some strategies facilitating the planning and execution of a Class IV restoration in the maxillary central incisor with nanoparticle composites through the use of a chromatic map, followed by a mock-up. After 15 days, the assay was evaluated and the definitive restoration was fabricated, followed by the final finishing, polishing and texturing to mimic the tooth structure...

Previsibilidade e segurança na reabilitação estética anterior usando-se laminados cerâmicos: relato de caso clínico / Predictability and safety in esthetic rehabilitation in anterior teeth using porcelain laminate veneers: a case report

A odontologia restauradora preconiza que o profissional deve sempre optar pelo tratamento menos invasivo possível, evitando maiores desgastes do elemento dental. A partir desse contexto, as facetas cerâmicas têm sido largamente utilizadas na reabilitação estética anterior, por representarem uma das soluções estéticas mais seguras e conservadoras. O propósito deste trabalho é descrever um caso de reabilitação estética anterior superior com uso de laminados cerâmicos, a partir do enceramento diagnóstico e mock-up, até a cimentação das restaurações definitivas. O uso de facetas cerâmicas demonstra ser procedimento que possibilita previsibilidade na modificação da forma dos dentes, proporcionando harmonia estética e alcançando sucesso clínico.

Today’s Restorative Dentistry establishes that the professional should always decide for the minimally invasive treatment, avoiding significant wear of the tooth. From this context, porcelain laminate veneers are being widely used in esthetic rehabilitation of anterior teeth because they are a safe, conservative alternative. The aim of this study is to describe a case of esthetic rehabilitation of maxillary incisors using porcelain laminate veneers, from diagnostic waxing and mock-up until the cementation of the final restorations. It can be concluded that the use of ceramic veneers is a safe, predictable procedure that allows to modify the shape of the teeth, providing esthetic harmony and reaching clinical success.