Characteristics of secondary caries lesion around composite resin restorations / Características da cárie secundária adjacente a restaurações de resinacomposta

Objetivo: O objetivo deste estudo foi analisar as características de cárie secundária e sua relação com a presença de restaurações com defeitos marginais como gap, degrau negativa (NL, a falta de material restaurador) e degrau positiva (PL, saliência). Materiais e Métodos: Oitenta superfícies proximais de restaurações de resina classe II foram fotografados e analisados utilizando um microscópio estereoscópico (X40). Foi registrada a presença de cáries secundárias externas, gaps, NL, PL e após a remoção de restaurações, a presença de lesão interna. Todos os exames foram realizados em 10 pontos bem definidos. Resultados: A prevalência de cárie secundária e gap foram associados com margem gengival. As restaurações com defeitos marginais (NL e PL) não foram associados a qualquer local específico (vestibular, lingual ou gengival). Observou-se uma relação entre esses defeitos com a prevalência de cárie secundária. A presença da lesão interna foi associada com lesão externa. Embora, em 141 pontos foi observada lesão interna, sem a presença de lesão externa. A maioria destas lesões mostraram envolvimento de esmalte interno. Apenas 8 por cento tinham desmineralização restrito a dentina, que poderia sugerir cárie residuais.

Objective: The aim of this study was to analyze the features of secondary caries and their relationship with the presence of restorations marginal defects as gap, negative ledge (NL, lack of restorative material) and positive ledge (PL, overhang). Materials and methods: Eighty proximal surfaces of Class II resin restorations were photographed and analyzed using a stereomicroscope (X40). It was recorded the presence of external secondary caries, gaps, NL, PL and after the restorations removal, the presence of internal lesion. All the exams were done in 10 welldefined points. Results: The prevalence of secondary caries and gap were associated with gingival margin. The restorations marginal defects (NL and PL) were not associated with any specific location (buccal, lingual or gingival). It was observed a relationship between these defects with secondary caries prevalence (gap: p= 0.004; NL and PL: p= 0.017). This association could be explained by the biofilm accumulation usually observed in the interface tooth surface/ restoration marginal defects. The presence of internal lesion was associated with external lesion. Although, in 141 points was observed internal lesion without the presence of external lesion. The majority of these lesions showed internal enamel involvement. Only 8 percent had demineralization restricted to dentine, which could suggest residual caries. Conclusion: The results of this study showed that secondary caries lesion frequently began externally on the interface tooth/restoration, where diagnose, control and arrestment of the lesions is possible.

Selle marginal y asentamiento en dos sistemas cerámicos in-vitro / Marginal sealing and bonding in two ceramic systems in vitro

La rehabilitación oral en odontología demanda la búsqueda constante de nuevos materiales cada vez más biocompatibles y con apariencia más natural para satisfacer las necesidades actuales de los pacientes. El objetivo de esta investigación fue comparar, en un estudio cuasiexperimental in vitro, el nivel de asentamiento y selle marginal de cofias elaboradas según dos sistemas comerciales totalmente cerámicos, cuando fueron cementadas sobre dientes naturales. Para el estudio se utilizaron 30 dientes naturales extraídos por requerimientos ortodónticos en los cuales se realizaron sendas preparaciones dentarias estandarizadas para prótesis fija según las recomendaciones de ambos fabricantes y se tomaron impresiones estandarizadas en silicona. A partir de los modelos obtenidos mediante estas impresiones se fabricaron y se evaluaron las cofias de los sistemas libres de soporte metálico In Ceram® de la casa VITA y Empress 2® de la casa IVOCLAR simulando una situación clínica. En las 30 cofias obtenidas para los dientes naturales, se aplicaron dos medidas para evaluar el selle marginal y cinco medidas para determinar el grado de asentamiento por medio de la medición directa en el estereomicroscopio de luz, con el cual los resultados se obtuvieron en micras. El análisis de los datos se hizo mediante estadística descriptiva empleando la prueba estadística t de Student, comparando los promedios de los resultados entre los dos grupos experimentales, con una significancia estadística de p<0.05. Los promedios de las medidas de asentamiento se tomaron en los cortes en 5 puntos de referencia en ambos sistemas; en 3 delos 5 puntos los promedios fueron menores en el sistema Empress 2®, que sus correspondientes promedios por punto para el sistema In Ceram®.

Oral rehabilitation procedures constantly demand searching for more biocompatible materials with natural appearance to satisfy patient requirements. The objective of this investigation was to compare the accuracy level of fitness and marginal seal in vitro of abutments made of two commercial totally-ceramic systems on natural teeth. To obtain the pertinent data a quasi-experimental in vitro study was design; 30 natural teeth extracted by orthodontic requirements were experimentally prepared as abutments to receive and support prosthetic dental crowns prepared following the manufacturers’ recommendations. The reconstructive materials used and evaluated were the totally-ceramic systems In Ceram® (VITA) and Empress 2® (IVOCLAR). Each natural tooth was prepared in a standardized dental preparations for fixed prosthetics, and standardized silicone impressions were built simulating a clinical situation. Thirty abutments for the natural teeth were obtained, evaluating two measures of marginal sealing and five measures of adaptation by direct measuring from light stereomicroscopy in microns. For the data analysis, descriptive statistic was used by means of statistical test t of Student, by comparison between both experimental groups, with a statistical significance of p<0.05. The averages of adaptation levels measured for 5 reference points in cuts made in both systems, were smaller in 3 points for the system Empress 2 ® than those corresponding to in the In Ceram® system. For the marginal seal, the averages of the measures in 2 reference points were considered for both systems, resulting smaller in one point for the Empress 2® system, and equal for the other point. When the averages between both groups were compared, statistically significant differences were found in 3 of the 7 points used as reference. On the other four points there were no significant differences.