Influence of pH-cycling and abrasion wear on the mechanical properties of conventional and bulk fill resin composites

The objective of this study was to evaluate the effect of abrasion wear on surface roughness and microhardness of different commercially available resin composites simulating pH-challenges of the oral cavity. Methods: Three resin composites (RC) were used in this study: one conventional: Z250; and two bulk fill resin composites (BRC): Tetric N-Ceram (TNC) and Sonic Fill (SF). The RC was inserted in a prefabricated mold (15mm wide x 4mm thickness) in two layers, or in a single layer for BRC. Thirty samples were prepared and surface roughness (Ra) and Knoop microhardness (KHN) test were performed at three different time-points of evaluation: baseline (24h after sample preparation); partial (after pH cycling); and final (after simulated toothbrushing procedure). Two samples of each group were selected after different treatments and analyzed descriptively on a scanning electron microscopy (SEM). Data from Ra and KHN were analyzed by two-way repeated-measures ANOVA and Bonferroni's post-hoc test with a significance level set at 5%. Results: Ra increased for all groups (p<0.001), at the final time-point, Z250 and TNC groups present the highest values. Oppositely, KHN decreased for all groups (p<0.001), Z250 group showed the highest KHN values for all time-points (p<0.001). The SEM imagens showed a regular surface for samples cycled and irregular with inorganic particles exposed for samples toothbrushed. Conclusion: pH-cycling and simulated toothbrushing affected the superficial properties (roughness and Knoop microhardness), as observed at SEM imagens, with irregular surface with inorganic particles exposure

Repair Adhesive Strength of Conventional and Bulk Fill Resins Using Different Bonding Techniques / Resistência Adesiva de Reparo em Resinas Compostas Convencionais e 'Bulk-Fill' Utilizando Diferentes Técnicas de Adesão

This research aimed to evaluate the bond strength by micro tensile strength (µTBS), elastic modulus (EM) and flexural strength (FS) by the three-point test using three types of composite resins: Charisma Diamond, Filtek Z350 and Tetric N-Ceram Bulk Fill; and three adhesion techniques: adhesive, silane, silane and adhesive. The combinations of each resin with the adhesive technique resulted in nine groups (n = 12). Initially, with the composites, EM and FS tests were performed. Sequentially, each fragment was repaired with the different adhesive systems. All samples were subjected to µTBS testing on a universal assay machine. Data were subjected to the normality test and the parametric ANOVA test. Charisma resin showed the highest values in EM and RF compared to the other composite resins (p <0.05). The highest µTBS value was for silane + adhesive repaired Charisma resin. The lowest µTBS values were in Bulk Fill resin, regardless of adhesive system. The EM and FS results showed that Filtek Z350 resins had the best results, while bulk fill resins had lower results. It was concluded that Charisma and Filtek Z350 resins presented better results. However, in the bulk fill group, the lowest mean values of µTBS, FS and EM were obtained, as well as the lowest value in EM. (AU)

Esta pesquisa teve como objetivo avaliar a resistência de união (RU) por resistência à microtração, módulo de elasticidade (ME) e resistência à flexão (RF) pelo teste de três pontos, utilizando três tipos de resinas compostas: Charisma Diamond, Filtek Z350 e Tetric N-Ceram Bulk Fill; e três técnicas de adesão: adesivo, silano, silano e adesivo. As combinações de cada resina com a técnica adesiva resultaram nove grupos (n = 12). Inicialmente, com os compósitos foram realizados testes de ME e RF. Sequencialmente, cada fragmento foi reparado com os diferentes sistemas adesivos. Todas as amostras foram submetidas ao teste de RU por microtração em uma máquina de ensaio universal. Os dados foram submetidos ao teste de normalidade e ao teste paramétrico ANOVA. A resina Charisma apresentou os maiores valores no ME e RF em relação às demais resinas compostas (p <0,05). O maior valor de RU foi para a resina Charisma reparada com silano + adesivo. Os menores valores de RU foram na resina Bulk Fill, independentemente do sistema adesivo. Os resultados no ME e RF mostraram que as resinas Filtek Z350 obtiveram os melhores resultados, enquanto as resinas bulk fill obtiveram resultados inferiores. Conclui-se que as resinas Charisma e Filtek Z350 apresentaram melhores resultados. Entretanto, no grupo de bulk fill obteve-se as menores médias de RU, RF e ME, bem como o menor valor no ME. (AU)

The finish line location of the cemented crown is an influencing factor for tensile bond strength, marginal adaption and nanoleakage? / A localização do término marginal em coroas cimentadas é um fator que influencia a resistência à tração, adaptação marginal e nanoinfiltração?

Objective: The aim of this study was to evaluate the influence of different crowns finishing line location on the crown tensile bond strength, marginal adaption and nanoleakage. Material and Methods: Sixty healthy third molars were collected. For tensile bond strength, a self-adhesive resin cement was used. For marginal adaption, epoxy resin models were prepared. Prior to tensile bond strength test, images for the epoxy resin models were measured under scanning electron microscopy (SEM). Nanoleakage was measured using same protocol. Failure mode was evaluated through SEM and classified: adhesive failure, cohesive in cement, cohesive in dentin, cohesive in resin composite, cohesive in enamel, and mixed. Statistical analysis was performed using Shapiro-Wilk and Kolmogorov Smirnov normality tests, two-way ANOVA, Bonferroni (posthoc) parametric test, with significance level of 5% (P < .05), Spearman correlation test. Results: tensile bond strength was not statistically different between the cemented groups with composite resin and ceramic. Cementation of ceramic was not statistically different between the groups (enamel, 3.28 Pa; dentin, 3.14 Pa; resin, 2.85 Pa). Marginal adaption was statistically different between resin and ceramic; finish line location varied between enamel and resin (175.91 µm vs. 433.58 µm). Nanoleakage rate was statistically different among all groups, except for resin: with resin (9.49%) and ceramic (9.35%). There was a predominance of adhesive failure in all groups. Conclusion: finish line location can be performed safely in enamel and dentin. Composite resinas substrate present an alternative, but still need to be more studied. Regarding the crown's material, it is possible to perform a satisfatory restoration in both: resin and ceramic. With ceramics presenting better results. (AU)

Objetivo: O objetivo deste estudo foi avaliar a influência da localização do término marginal na cimentação de coroas, na resistência à tração, adaptação marginal e nanoinfiltração, de acordo com os fatores: término marginal (dentina, esmalte e resina composta), e material restaurador (resina composta e cerâmica). Material e Métodos: Foram coletados 60 terceiros molares hígidos. Para o teste de resistência à tração, todas as amostras foram praparadas com término em chanfro e um cimento resinoso autoadesivo foi utilizado para a cimentação. Para a avaliação da adaptação marginal, foram confeccionados modelos em resina epóxica da linha de cimentação das amostras, previamente ao teste de tração, e submetidas à avaliação em microscopia eletrônica de varredura (MEV), para obtenção de imagens que posteriormente foram mensuradas. Para a nanoinfiltração, foram confeccionados fragmentos dos substratos e materiais restauradores, que foram cimentados com o mesmo protocolo. As amostras/imagens foram obtidas em MEV e mensurada a área infiltrada. O padrão de fratura foi avaliado através de imagens obtidas no MEV e classificados em: falha adesiva, coesiva em cimento, coesiva em dentina, coesiva em resina composta, coesiva em esmalte e mista. A análise estatística foi realizada utilizando os testes de normalidade Shapiro-Wilk e Kolmogorov Smirnov, ANOVA a dois fatores, teste paramétrico Bonferroni (post-hoc), com nível de significância de 5% (P <0,05), teste de correlação de Spearman. Resultados: a resistência à tração não foi estatisticamente diferente entre os grupos cimentados com resina composta e cerâmica. A cimentação da cerâmica não foi estatisticamente diferente entre os grupos (esmalte, 3,28 Pa; dentina, 3,14 Pa; resina, 2,85 Pa). A adaptação marginal foi estatisticamente diferente entre resina e cerâmica; a localização da linha de chegada variou entre esmalte e resina (175,91 µm vs. 433,58 µm). Para a nanoinfiltração foi estatisticamente diferente entre todos os grupos, exceto a resina: com resina (9,49%) e cerâmica (9,35%). Houve predomínio de falha adesiva em todos os grupos. Conclusão: a localização da linha de chegada pode ser realizada com segurança no esmalte e dentina. O substrato em resina composta apresenta uma alternativa promissora, mas ainda precisa ser mais estudado. Em relação ao material da coroa, é possível realizar uma restauração satisfatória tanto em resina composta quanto em cerâmica. Sendo a cerâmica, o material que apresentou melhores resultados. (AU)

Glass fiber posts: influence of cementation techniques on push-out bond strength

Aim: Glass fiber posts are indicated in the rehabilitation of extensively damaged teeth; their cementation represents a critical step in restorative dentistry. The aim of this study was to quantify and compare the push-out bond strength of glass fiber posts cemented by conventional technique, two-step technique with luting agent and two-step technique associating bulk-fill composite and luting agent. Methods: Eighty maxillary bovine incisors were endodontically treated and divided into eight groups (n = 10) according to the luting agent (Rely X ARC and Duo-link) and cementation technique (conventional technique; two-step technique with luting agent; and two-step technique associating bulk-fill composite ­ Filtek Bulk-fill flow or Surefil SDR flow ­ and luting agent). Samples were submitted to pushout bond strength test, and the fracture pattern was evaluated through scanning electron microscope. Data were submitted to two-way ANOVA and Tukey's test (α = 0.05). Results: When Rely X ARC was used, the conventional cementation technique obtained higher bond strength values than the twostep technique associated with Filtek Bulk-fill flow. When Duolink was used, the two-step technique associated with Filtek Bulk-fill flow presented higher bond strength values than the conventional technique. The most prevalent fracture patterns were adhesive between luting agent and dentin, and adhesive between bulk-fill composite and dentin. Conclusion: Two-step cementation technique associated with bulk-fill composite may be promising depending on the luting agent used

Light curing resin cements containing iodonium salts promote suitable apical bonding of posts to radicular dentin

Abstract The aim of this study was to analyze the efficiency of experimental light-curing resin cements (ERCs) with a ternary photo-initiator system containing diphenyliodonium hexafluorphosphate (DPI) and different amines on retention of glass-fiber posts to dentin (GFP). ERCs formulations: a 1:1 mass ratio of 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenylpropane and triethyleneglycol dimethacrylate. Camphorquinone was used as initiator. Six experimental groups were established according to the amine used: [ethyl-4-(dimethylamino)benzoate-EDMAB or 2-(dimethylamino)ethyl methacrylate-DMAEMA] and the concentration of DPI (0, 0.5 mol%, 1 mol%). The resin cements Variolink II (dual- and light-cured versions) were used as commercial reference. Eighty recently extracted bovine incisors (n = 10) were selected for this study. The roots were prepared and the fiber posts were cemented with the resin cement specified for each experimental group. Specimens from coronal, middle, and apical thirds of the root were subjected to push-out bond strength test 24 hours after bonding. Data were subjected to split-plot ANOVA and the Tukey test (p = 0.05). ERCs containing DPI showed statistically significant higher bond strengths compared with ERCs without DPI. ERCs containing DPI were statistically similar to VARIOLINK II - dual-cured and superior to VARIOLINK II - light-cured (except for EDMAB - 1DPI in the medium third and DMAEMA - 1DPI in the coronal third). Different amines did not influence post retention. The apical root region showed the lowest bond strength for the groups EDAB-0DPI, DMAEMA-0DPI and VARIOLINK II light-cured. Light-cured ERCs containing DPI were efficient for GFP retention to radicular dentin, with similar behaviour to that of dual-curing commercial resin cement.

The effect of hydrofluoric acid and resin cement formulation on the bond strength to lithium disilicate ceramic

Abstract To investigate how the hydrofluoric acid (HF) concentrations applied to a lithium disilicate glass-ceramic (EMX) affects the surface morphology and microtensile bond strength (μTBS) of ceramics to dentin, using light-cured resin cements with or without UDMA. Sixty-three EMX square ceramic blocks were etched for 20 seconds using different HF concentrations (1%, 5% and 10%) and luted to dentin using two types of resin cement combinations: BisGMA/TEGDMA and BisGMA/TEGDMA/UDMA (n = 10). Each bonded EMX-dentin block was sectioned to obtain 1 mm2 sticks for μTBS evaluation. Half of the sticks were tested after 24 hours and the other half was assessed after 6 months of water storage. Data were statistically assessed using split-plot three-way ANOVA and multiple comparisons were performed using the Tukey's post hoc test (α = 0.05). One EMX sample from each HF concentration was analyzed using field-emission scanning electron microscope (FE-SEM) to characterize the etching pattern. According to the FE-SEM images, increasing the concentration of HF from 1 to 5 and then to 10% led to increased removal of glassy matrix and greater exposure of lithium disilicate crystals. The 10% HF concentration yielded higher μTBS when compared to 1% for BisGMA/TEGDMA formulation (p < 0.05); whereas HF 1% and 5% showed similar μTBS values when compared to 10% HF for BisGMA/TEGDMA/UDMA resin matrix (p > 0.05) at both storage times. Water aging decreased the μTBS values (p < 0.05), except when 10% HF was associated with BisGMA/TEGDMA resin cement. Resin cement formulation and hydrofluoric acid concentrations can interfere with the immediate and long-term glass-ceramic bond strength to dentin.

The Effect of Hydrofluoric Acid Concentration and Heat on the Bonding to Lithium Disilicate Glass Ceramic

Abstract The aim of this study was to evaluate the effects of hydrofluoric acid (HF) concentration and previous heat treatment (PHT) on the surface morphology and micro-shear bond strength (mSBS) of a lithium disilicate glass ceramic (EMX) to resin cement. One hundred four EMX specimens were randomly assigned to two groups (n=52) according to the HF concentration: 5% and 10%. A new random distribution was made according to the PHTs (n=13): control (no PHT); previously heated HF (70 °C); previously heated EMX surface (85 °C); the combination of heated HF + heated EMX surface. The etching time was set at 20 s. All EMX blocks were silanated and received a thin layer of an unfilled resin. Five resin cement cylinders were made on each EMX surface using Tygon tubes as matrices, and then stored for 24 h at 37 °C. One random etched EMX sample from each group was analyzed using field-emission scanning electron microscopy (FE-SEM). The data were subjected to two-way ANOVA and multiple comparisons were performed using the Tukey post hoc test (a=0.05). For the control groups, 5% HF showed statistically lower mSBS values when compared to 10% HF (p<0.05). PHT increased the mSBS values for 5% HF, yielding statistically similar results to non-PHT 10% HF (p<0.05). FE-SEM images showed increased glassy matrix removal when PHT was applied to HF 5%, but not to the same degree as for 10% HF. PHT has the potential to improve the bond strength of 5% HF concentration on lithium disilicate glass ceramic.

Resumo O objetivo deste estudo foi avaliar os efeitos das concentrações de ácido fluorídrico (AF) e do prévio tratamento térmico (PTT) na morfologia da superfície e resistência de união ao microcisalhamento (mRUM) de uma cerâmica vítrea de dissilicato de lítio (EMX) ao cimento resinoso. Cento e quatro espécimes de EMX foram aleatoriamente distribuídos em dois grupos (n=52) de acordo com a concentração do AF: 5% e 10%. Os espécimes foram novamente distribuídos de forma aleatória de acordo com o PTT (n=13): controle (sem PTT); AF previamente aquecido (70 °C); superfície do EMX previamente aquecida (85 °C); combinação entre AF e EMX aquecidos. O tempo de condicionamento foi fixado em 20 s. Todos os espécimes de EMX foram silanizados e receberam a aplicação de uma fina camada de um adesivo sem carga. Cinco cilindros de cimento resinoso foram confeccionados usando tubos Tygon como matrizes e então armazenados por 24 h a 37 °C. Uma amostra condicionada de cada grupo foi aleatoriamente selecionada e analisada em um microscópio eletrônico de varredura em emissão de campo (MEVEC). Os dados foram submetidos ao teste ANOVA de dois fatores e múltiplas comparações foram feitas pelo teste de Tukey (a=0.05). Para os grupos controle, AF 5% mostrou valor de mRUM estatisticamente menor do que AF 10% (p<0.05). PTT aumentou os valores de mRUM para o AF 5%, proporcionando resultados estatisticamente similares ao grupo AF 10% controle (p<0.05). MEVEC mostrou um aumento na remoção da matriz vítrea quando o PTT foi aplicado ao grupo AF 5%, no entanto esse efeito não foi visto no grupo AF 10%. O PTT tem o potencial de melhorar a resistência de união do AF 5% na cerâmica vítrea reforçada por disilicato de lítio.

Microtensile Bond Strength of Methacrylate and Silorane Resins to Enamel and Dentin

The aim of this study was to evaluate the microtensile bond strength (µTBS) of two substrates (enamel and dentin) considering two study factors: type of composite resin [methacrylate-based (Filtek Supreme) or silorane-based (Filtek LS)] and aging time (24 h or 3 months). Twenty human molars were selected and divided into 2 groups (n=10) considering two dental substrates, enamel or dentin. The enamel and dentin of each tooth was divided into two halves separated by a glass plate. Each tooth was restored using both tested composite resins following the manufacturer's instructions. The samples were sectioned, producing 4 sticks for each composite resin. Half of them were tested after 24 h and half after 3 months. µTBS testing was carried out at 0.05 mm/s. Data were analyzed by three-way ANOVA and Tukey's HSD tests at α=0.05. Significant differences between composite resins and substrates were found (p<0.05), but no statistically significant difference was found for aging time and interactions among study factors. The methacrylate-based resin showed higher µTBS than the silorane-based resin. The µTBS for enamel was significantly higher than for dentin, irrespective of the composite resin and storage time. Three months of storage was not sufficient time to cause degradation of the bonding interaction of either of the composite resins to enamel and dentin.

O objetivo deste estudo foi avaliar a resistência adesiva por meio do teste de microtração (µTBS) entre dois substratos (esmalte e dentina) considerando dois fatores em estudo: Tipo de resina [metacrilato (Filtek Supreme) ou silorano (Filtek LS)] e tempo de envelhecimento (24 horas ou 3 meses). Vinte molares humanos foram selecionados e divididos em dois grupos (n=10) considerando dois substratos dentários, esmalte e dentina. O esmalte e a dentina de cada dente foram divididos em duas metades, por meio de uma lamínula. Cada dente foi restaurado usando ambas as resinas testadas, seguindo instruções do fabricante. As amostras foram seccionadas, resultando em quatro palitos para cada tipo de resina. Metade dos palitos foi testada após 24h e o restante após três meses. O ensaio de microtração (µTBS) foi conduzido numa velocidade de 0,05 mm/s. Os dados foram analisados usando three-way ANOVA e teste de Tukey HSD (α= 0,05). Diferença significante foi encontrada para o fator resina e substratos (p<0,05), porém não houve influência do tempo de envelhecimento e interações entre fatores estudados. A resina à base de metacrilato apresentou maior resistência adesiva do que a silorano. A adesão em esmalte foi significativamente maior do que em dentina, independente da resina e do tempo de envelhecimento. Três meses de armazenamento não foram suficientes para causar degradação da interação adesiva, para ambas as resinas compostas, no esmalte e na dentina.

Marginal adaptation of class V composite restorations submitted to thermal and mechanical cycling

Objective: This study evaluated the effect of the margin location and an adhesive system on the marginal adaptation of composite restorations. Material and Methods: Class V cavities were prepared in bovine teeth with the gingival margin on the dentin and the incisal margin on the enamel. The cavities were restored with a micro-hybrid composite resin using an etch-and-rinse [Single Bond 2 (SB)] or a self-etching adhesive [Clearfil SE Bond (CL)]. After finishing and polishing the restorations, epoxy replicas were prepared. The marginal adaptation was analyzed using scanning electronic microscopy (SEM, 500 x magnification). The higher gap width in each margin was recorded (T0). After the first evaluation, the samples were submitted to thermal cycling (2,000 cycles of 5°C±2°C followed by 55°C±2°C – T1) and mechanical cycling (100,000 cycles of 50 kN and 2 Hz – T2). Replicas of samples were rebuilt after each cycling and analyzed under SEM. The data were submitted to Mann-Whitney, Wilcoxon and Friedman testing (á=0.05). Results: The SB presented higher gaps in the dentin than the enamel, while there was no difference between the substrate for the CL. In the dentin, the CL showed better marginal sealing than the SB. The opposite occurred in the enamel. There were no significant differences between the baseline, thermal and mechanical cycling for any experimental condition. Conclusions: The outcomes of the present study showed that the adhesive system and margin location have an important effect on the marginal adaptation of composite restorations.

Técnicas restauradoras para fraturas coronárias de dentes anteriores traumatizados / Restorative techniques for anterior coronal fractured teeth

Mudanças nos padrões de beleza estimulam cada vez mais pessoas a procurar tratamento odontológico com resultado estético de alta excelência. O objetivo deste artigo foi abordar diferentes técnicas restauradoras diretas para fraturas coronárias de dentes anteriores traumatizados, enfatizando os protocolos clínicos, suas vantagens e desvantagens. Dessa forma, três relatos de casos são ilustrados e discutidos. Na primeira situação clínica, paciente de 28 anos relatou ter sofrido trauma dentário, no dente 21, durante prática esportiva na infância e sentia-se insatisfeita devido a frequente perda de retenção e falha estética apresentada pela restauração. Foi proposta a substituição da restauração por inserção direta, à mão livre, em resina composta, utilizando-se a estratificação ou técnica anatômica. O segundo relato de caso trata-se de paciente jovem, 14 anos, com fratura no dente 21 e restauração insatisfatória no dente 11. Optou-se pela técnica da moldagem, enceramento e reabilitação, utilizando-se guia de silicone. O terceiro caso clínico corresponde à paciente de 11 anos de idade, com fratura coronária do dente 11, com exposição pulpar. Entretanto, neste caso, o paciente apresentava-se com o fragmento dentário, sendo indicada a colagem. Pode se concluir que a escolha da técnica restauradora deve adequar-se às possibilidades e necessidades de cada paciente, sendo fundamental o conhecimento científico e habilidade do cirurgião dentista. Dentre as técnicas descritas neste artigo, todas apresentam resultados estéticos satisfatórios. A colagem do fragmento autógeno é fácil, rápida e conservadora, além de permitir a manutenção da textura, forma e propriedades ópticas e mecânicas originais.

Changes in beauty standards encourage people to seek dental treatment with a high excellence esthetic result. The aim of this article is to address different direct restorative techniques for anterior coronal fractured teeth, emphasizing advantages and disadvantages of clinical protocols. Thus, three case reports are discussed. In the first clinical situation, a 28 years-old patient suffered a dental trauma on the tooth 21 during sports practice in childhood. The patient was unsatisfied with the frequent loss of retention and esthetic failure presented by the restoration. It was proposed to replace it for free-hand direct insertion and composite resin using the layering or anatomical technique. The second clinical case is a fracture in tooth 21 and an unsatisfactory restoration in tooth 11 of a 14 years-old patient. The casting, waxing and rehabilitation techniques were chosen by using a silicone guide. The third clinical case was an 11 years-old patient with crown fracture in tooth 11 and pulp exposure. As the patient had the dental fragment, the bonding of it was indicated. It can be concluded that the choice of appropriate technique must consider the possibilities and needs of each patient, being fundamental both scientific knowledge and skill of the dentist. Among the techniques described in this article, all present satisfactory cosmetic results. The autogenous bonding of the fragment is easy, fast and conservative, and it allows the maintenance of texture, shape and unique optical and mechanical properties.

Impact of rehabilitation with metal-ceramic restorations on oral health-related quality of life

Dental ceramics present excellent ability to reproduce the natural teeth regarding esthetic and biomechanics. Recently, due to the advancement of ceramic technology, metal-free restorations were developed. However, the traditional metal-ceramic restorations still present the requirements of high strength, long survival in the oral environment and favorable aesthetics. In this context, it is essential to know the specificity of each ceramic system available in order to apply it properly to various clinical situations. This report describes an integrated rehabilitation using metal-ceramic restorations of a patient at 50 years of age, who presented edentulous spaces, and previous unsatisfactory composite and amalgam restorations, and indirect metallic restorations, leading to compromised quality of life in both functional and psychosocial aspects. The impact on quality of life was measured using a generic instrument, OHIP-14, validated for the World Health Organization, which covers both the biological and the psychosocial dimensions. This instrument was applied to the patient before and after treatment. The patient had an overall OHIP-14 score of 28 before the treatment and after treatment the score decreased to 0, showing that dental and oral health conditions are factors that do impact on the quality of life. Rehabilitation has provided functional and aesthetic restorations, harmony of the stomatognathic system and improvement of life quality.

As cerâmicas dentais são conhecidas pela excelência em reproduzir artificialmente dentes naturais. Recentemente, devido ao aprimoramento da tecnologia cerâmica, surgiram as restaurações livres de metal. Entretanto, as tradicionais metalocerâmicas ainda preenchem adequadamente os requisitos de alta resistência, longa sobrevida em meio bucal e estética favorável. Neste contexto, é fundamental conhecer a especificidade de cada sistema cerâmico a fim de indicá-lo adequadamente às diversas situações clínicas. Este artigo relata um caso de reabilitação integral e integrada de paciente de 50 anos de idade, portador de espaços edêntulos, restaurações protéticas posteriores e restaurações diretas anteriores insatisfatórias, resultando em comprometimento da qualidade de vida nos âmbitos funcional e psicossocial, utilizando coroas metalocerâmicas. O impacto na qualidade de vida foi mensurado utilizando um instrumento genérico, OHIP-14, validado pela Organização Mundial de Saúde, que abrange tanto a dimensão biológica, como a dimensão psicossocial. Este instrumento foi aplicado à paciente antes e após o tratamento, obtendo pontuação total de 28 e 0 respectivamente, o que mostra que a condição de saúde oral representa fator de grande impacto sobre a qualidade de vida. A reabilitação oral proporcionou restabelecimento funcional e estético, harmonia do sistema estomatognático e melhoria da qualidade de vida da paciente.

Avaliação de métodos para mensuração da adaptação marginal e espessura de linha de cimentação em restaurações indiretas / Evaluation of methods for measurement of marginal adaptation and cement thickness on indirect restorations

Objetivos: Comparar métodos utilizados na mensuração da adaptação marginal e espessura de linha de cimentação em restaurações indiretas do tipo inlay. Materiais e método: Foram confeccionados preparos cavitários para inlay em 24 terceiros molares humanos, assim como restaurações inlays em resina composta. Metade das amostras foi utilizada para avaliar, sem a cimentação da restauração, a adaptação marginal, ao passo que as demais foram cimentadas e a espessura da linha de cimentação foi mensurada. Foram feitas avaliações nas regiões cervical, interproximal e oclusal, utilizando-se três metodologias: lupa estereoscópica, microscopia óptica e microscopia eletrônica de varredura, sendo que com esta última avaliou-se apenas a região oclusal. Resultados: Para avaliação da adaptação marginal, não houve diferença entre a lupa estereoscópica e microscopia óptica. Quando foi mensurada a linha de cimentação, a lupa apresentou menor valor na região interproximal. A microscopia eletrônica de varredura apresentou os menores valores. Conclusões: Para medir adaptação de peças em um preparo pode-se utilizar tanto lupa estereoscópica quanto microscopia óptica. Para avaliar a linha de cimentação o melhor método é MEV.

Odontologia integrada para restabelecimento estético e funcional do sorriso / The integrated dentistry to obtain an aesthetic and functional smile

A inter-relação entre as diversas áreas da Odontologia é importante no restabelecimento estético e funcional de dentes com grandes perdas estruturais O desenvolvimento e a utilização de materiais que mimetizem as características mecânicas dos tecidos dentários têm se tornado muito frequentes, com o intuito de preservar a integridade das estruturas dentárias remanescentes. 0 tracionamento ortodôntico na região anterior tem sido cada vez mais empregado para devolver biologia e estética dessa região. Em casos clínicos onde a estética é fundamental, deve-se integrar a estética dental com a gengival. 0 objetivo deste relato de caso clínico foi mostrar como as diferentes áreas da Odontologia podem trabalhar juntas no planejamento e na resolução de alterações estéticas e funcionais da cavidade oral causada por traumatismos dentários, obtendo-se excelência estética com satisfação mútua, do profissional e do paciente.

Restauração com pinos intrarradiculares anatômicos em grandes destruições coronárias / Restoration with intraradicular anatomical posts in flared root canals

o tratamento endodôntico em dentes com grande destruição coronária é um procedimento clínico comum no cotidiano das clínicas odontológicas. Na maioria destas situações clínicas, há a indicação do uso de retentor intrarradicular para dar estabilidade e retenção à restauração. Uma das técnicas propostas para o tratamento de canais amplos é a utilização de um pino de fibra de vidro com módulo de elasticidade próximo ao da dentina, remodelado com resina composta para preencher o espaço existente no canal radicular alargado. Esta técnica reduz quantidades excessivas de cimento que serviriam para substituir a estrutura dental perdida e permite uma boa adaptação no conduto radicular, criando condições favoráveis para retenção do pino. O objetivo deste trabalho foi demonstrar a técnica de anatomização de pinos intrarradiculares estéticos com resina composta, em incisivo anterior com grande destruição coronária. A utilização de um pino de fibra de vidro anatômico foi a alternativa indicada para a resolução clínica de forma a proteger o remanescente dental enfraquecido, além de obter estética aliada a um prognóstico favorável.

Root canal therapy in teeth with large coronal destruction is a common clinical precedure in the daily dental clinics. In most of these conditions, there is an indication of the use of intra-radicular post for stability and retention for the restoration. One of the techniques proposed for the treatment of enlarged channels, is the use of a fiber glass with modulus of elasticity similar to dentin, restored with composite resin to fill the space between the root canal extended. This technique reduces excessive amounts of cement that would serve to replace the lost tooth structure and allows a good adaptation in the root canal, creating favorable conditions for retention of the post. The objective was to demonstrate the technique of anatomization intraradicular aesthetic post with composite resin in anterior incisor with large coronal destruction. The use of a fiber glass anatomical was the alternative used for clinical resolution in order to reinforce the remaining tooth structure weakened, returning him to function without requiring the removal of sound tooth structure, and aesthetics combined with a more favorable prognosis.

Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots

Restoring flared endodontically treated teeth continues to be a challenge for clinicians. This study evaluated the effect of post types and restorative techniques on the strain, fracture resistance, and fracture mode of incisors with weakened roots. One hundred five endodontically treated bovine incisors roots (15 mm) were divided into 7 groups (n=15). The two control groups were (C) intact roots restored with Cpc (cast posts and core) or Gfp (glass fiber posts). The five experimental groups were (F) flared roots restored with GfpAp (Gfp associated with accessory glass fiber posts), GfpRc (anatomic Gfp, relined with composite resin), and GfpRcAp (anatomized Gfp with resin and accessory glass fiber posts). All teeth were restored with metal crowns. Mechanical fatigue was performed with 3x10(5)/50 N. Specimens were loaded at 45º, and the strain values (μS) were obtained on root buccal and proximal surfaces. Following that, the fracture resistance (N) was measured. One-way ANOVA and Tukey's HSD tests (α=0.05) were applied, and failure mode was checked. No significant difference in strain values among the groups was found. Cpc presented lower fracture resistance and more catastrophic failures in flared roots. Gfp associated with composite resin or accessory glass fiber posts seems to be an effective method to improve the biomechanical behavior of flared roots.

Restaurar dentes tratados endodonticamente continua sendo desafio para clínicos. Este estudo avaliou o efeito de pinos e técnicas na deformação, resistência à fratura e padrão de fratura de incisivos com canal radicular alargado. Cento e cinco raízes bovinas, tratadas endodonticamente (15 mm) foram divididas em 7 grupos (n=15). Os grupos controle (C), constituídos de raízes não alargadas, foram restauradas com Cpc (núcleo metálico fundido) ou Gfp (pino de fibra de vidro). Nos grupos experimentais os canais foram alargados (F) e restaurados com: GfpAp (Gfp associado com pinos de fibra de vidro acessórios); GfpRc (pino anatômico, reembasado com resina composta) e GfpRcAp (pino anatomizado com resina composta e pinos acessórios). Os dentes foram restaurados com coroas metálicas. Fadiga mecânica foi simulada com 3x10(5)/50 N ciclos. O teste foi realizado a 45º e a deformação (μS) obtida nas superfícies vestibular e proximal. Em seguida, a resistência à fratura (N) e o padrão de fratura foram verificados. Aplicou-se ANOVA e Teste de Tukey (α=0,05). Não houve diferença na deformação. Cpc resultou em menor resistência à fratura e com mais fraturas catastróficas em raízes fragilizadas. As técnicas de reembasamento do pino com resina composta ou o uso de pinos acessórios parecem ser efetivos para melhorar o comportamento biomecânico de raízes fragilizadas.

Associação de técnicas no tratamento restaurador em dentes posteriores: onlay cerâmico X resina composta / Association of techniques in restorative treatment of posterior teeh: ceramic onlay x composite resin

O aumento da demanda por restaurações estéticas é uma realidade na clínica odontológica, sendo que essa tendência é observada não só no tratamento de dentes anteriores, mas também na região posterior. Alternativas restauradoras, como o uso de resinas compostas diretas, inlays, onlays e coroas em resina ou cerâmica, visam o equilíbrio funcional e estético dos dentes posteriores. Entretanto, a escolha da técnica empregada está principalmente associada à técnica empregada, está principalmente associada à condição do remanescente dentário. Assim, através do relato de um caso clínico, esse artigo busca conceituar importantes aspectos quanto ao uso de resinas compostas e restaurações indiretas do tipo onlay cerâmicos, enfatizando a importância na indicação desses dois tratamentos restauradores estéticos para dentes posteriores.

Dual resin cement knoop hardness after different activation modes through dental ceramics

This study investigated the influence of ceramic compositions on Knoop Hardness Number (KHN) immediately and 24 h after polymerization and the effect of activation modes on the KHN of a resin cement. Ten Panavia F 2.0 resin cement discs were activated either directly using curing light, or chemically without light, or through 1.2-thick ceramic discs. The following ceramics were evaluated: Duceram, Cergogold, IPS Empress, IPS Empress 2, Procera, Cercon, In Ceram Alumina and In Ceram Zirconia. The KHN was obtained immediately and after 24-h testing time. Two-way ANOVA and Tukey's test were performed for statistical analysis (p<0.05). Direct activation showed higher KHN than activation through ceramics and chemical activation for both immediate and 24-h post activation. The KHN for 24-h post activation time was higher than that of the immediate post activation time except for the direct activation mode. The glass and di-silicate based ceramics showed higher KHN than alumina- and zirconia-based ceramics, immediately and after 24-h. The reinforced and opaque ceramics had the lowest KHN. The ceramic composition resulted in light attenuation, lower polymerization and lower KHN, and the 24-h testing time promoted an improvement of KHN except for direct activation mode.

Este estudo investigou a influência de composições de cerâmica no número de dureza Knoop (KHN), imediatamente e 24 h após a polimerização; e o efeito de modos de ativação na KHN de um cimento resinoso. Dez discos de cimento resinoso Panavia F 2.0 foram ativados diretamente usando uma fonte de luz, ou quimicamente sem luz, ou através de discos de cerâmica com espessura de 1,2 mm. As cerâmicas avaliadas foram Duceram, Cergogold, IPS Empress, IPS Empress 2, Procera, Cercon, In Ceram Alumina e In Ceram Zirconia. O KHN foi obtido nos tempos imediatamente e após 24 h. Os testes ANOVA two-way e Tukey foram realizados para a análise estatística (p<0,05). A ativação direta apresentou maiores KHN que a ativação através das cerâmicas e ativação química, para ambos os tempos testados imediatamente e após 24 h. O KHN para o tempo de ativação testado após 24 h foi superior que o tempo imediatamente, exceto para o modo de ativação direto. As cerâmicas à base de vidro e di-silicato apresentaram KHN superiores que as cerâmicas à base de alumina e zircônia, imediatamente e após 24 h. As cerâmicas mais reforçadas e opacas resultaram um dos menores KHN. A composição da cerâmica resulta em atenuação de luz, menor polimerização e menor KHN; e o tempo de 24 h testado promove uma melhora no KHN, exceto para o modo de ativação direto.

Effect of relining on fiber post retention to root canal

One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem. OBJECTIVES: The aim of this study was to evaluate the effect of fiber post relining with composite resin on push-out bond strength. MATERIAL AND METHODS: Twenty bovine incisors were selected to assess post retention. The crowns were removed below the cementoenamel junction and the root canals were treated endodontically and flared with diamond burs. The roots were allocated into two groups (n=10): G1: fiber posts without relining and G2: fiber posts relined with composite resin. The posts were cemented with a dual-cured resin cement and the specimens were sectioned transversally. Three 1.5-mm thick slabs were obtained per root and identified as cervical, medium and apical thirds. The push-out test was performed at a crosshead speed of 0.5 mm/min until post dislodgement occurred. The failure mode of fractured specimens was analyzed under scanning electron microscopy. Data were analyzed by split-plot ANOVA and post-hoc Tukey's test at a pre-set alpha of 0.05. RESULTS: Relined fiber posts presented higher retention values than non-relined post in all thirds. No statistically significant differences (p>0.05) were found among thirds for relined posts. All failures occurred at the interface between resin cement and root dentin. CONCLUSIONS: Relining with composite resin seems to be an effective method to improve the retention of fiber posts to flared root canals.

Effect of cavity preparation design on the fracture resistance of directly and indirectly restored premolar

Aim: The aim of this study was to evaluate the fracture resistance of human premolars with extensive cavity preparations of the inlay and onlay types, for performing direct and indirect composite resin restorations. Methods: Eight-four premolars were divided into 7 groups (n=12): G1=intact teeth; G2=inlay/Filtek Z-250 direct; G3=inlay/ Filtek Z-250 light polymerized indirectly; G4=inlay/ Solidex; G5=onlay/ Filtek Z-250 direct; G6=onlay/ Filtek Z-250 light polymerized indirectly; G7=onlay/ Solidex. Indirect Filtek Z- 250 restorations were light activated using the EDG-lux oven. All samples were submitted to axial compression load in a Universal Testing Machine until fracture. The data were submitted to the one-way ANOVA and Tukey’s test (a=0.05). Results: The results (N) were: G6-1938a, G5-1570ab, G7-1285b, G1-1215b, G4-1174b, G3-1146b and G2-1112b. The onlay cavities restored indirectly with Filtek Z-250 presented significantly higher fracture resistance (G6) than the other groups, except for onlay restorations made directly with Filtek Z-250 (G5), which, in turn, did not differ significantly from the other groups. However, the onlay restorations made with Filtek Z-250 led to more catastrophic failure modes. Conclusions: 1. Adhesive inlay restorations, irrespective of the type of composite resin and light-activation technique used, restored the fracture resistance of intact teeth.

The effect of luting techniques on the push-out bond strength of fiber posts

Aim: This study aimed to evaluate the effect of using a chemical co-initiator and/or an additional coat of a hydrophobic resin on the bond strength of fiber posts luted with a dual-cured resin cement. In addition, the use of the resin cement only was also evaluated. Methods: Fiber posts were luted with dual-cured resin cement (Enforce) and using one of five adhesive procedures: G1 - Prime&Bond 2.1 (PB), G2 - PB + Self-cure activator (SC), G3 - PB + bonding agent of Scotchbond Multi-Purpose (SMP), G4 – PB + SC + SMP and G5 – no adhesive. The root samples were sectioned transversally into three slabs (coronal, middle and apical third) that were submitted to push-out testing. Data were submitted to split-plot...