Bleaching efficacy of in-office dental bleaching with different application protocols: a single-blind randomized controlled trial.

OBJECTIVE: This randomized controlled trial aimed to evaluate the equivalence in the color change, adverse effects, self-perception (AS) and the impact on oral condition (IO) of participants submitted to different application protocols of in-office dental bleaching. MATERIALS AND METHODS: 165 participants were bleached with a 35% hydrogen peroxide gel (Total Blanc Office One-Step, DFL), according to the following protocols: (1) 2 applications of 20-min each (2 × 20 min); (2) 1 × 40-min and; (3) 1 × 30-min. The color change was evaluated with the Vita Easyshade spectrophotometer, Vita Classical and Vita Bleachedguide scales. The intensity and risk of tooth sensitivity (TS) and gingival irritation (GI) were recorded using a 0-10 visual analogue scale (VAS). AS and IO was assessed before and after the bleaching procedure using the Orofacial Aesthetic Scale and Oral Health Impact Profile-14, respectively. RESULTS: Equivalent color change were observed (p < 0.001), with no significant difference between groups. The group 2 × 20 min presented the highest risk of TS (76%, 95% CI 63 to 85), compared to the 1 × 30 min (p < 0.04). The intensity of TS and GI and the risk of GI was similar between groups (p > 0.31). Irrespectively of the group (p = 0.32), significant improvements were observed for all items of AS and IO after bleaching (p < 0.02). CONCLUSIONS: The 1 × 30 min protocol produced equivalent color change to the other bleaching protocols with reduced risk of TS and shorter application time. CLINICAL RELEVANCE: A more simplified application regimen of a single application of 30 min yields effective bleaching and patient satisfaction while minimizing undesirable side effects and improving patient satisfaction.

Clinical performance of posterior restorations using a universal adhesive over moist and dry dentin: A 36-month double-blind split-mouth randomized clinical trial.

OBJECTIVES: To evaluate the influence of dentin moisture on the clinical behavior of a universal adhesive on posterior teeth after 36 months of follow-up. METHODS: Forty-five patients participated in this study. Following a split-mouth design, three operators placed 90 Class I/Class II restorations over moist dentin (MD) or dry (DD) (n = 45) with resin composite (Filtek Bulk Fill) and a universal adhesive used in the etch-and-rinse mode (Single Bond Universal). Each restoration was evaluated according to the FDI and USPHS criteria (postoperative sensitivity, fracture and retention, marginal staining, marginal adaptation, and recurrence of caries) at baseline and after 6-, 12-, and 36 months. For statistical analysis, Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used. RESULTS: No significant difference between groups was observed in each FDI criterion after 36 months of clinical evaluation (p > 0.05). The retention rates (confidence interval 95 %) were 97.37 % (86.5 - 99.5) for both MD and DD without significant difference between them (p > 0.05). Eight restorations (MD = 4; DD = 4) showed minimal marginal staining defects (p > 0.05). Two restorations were lost (MD = 1; DD = 1). Fifteen restorations (MD = 8; DD = 7) presented minor marginal discrepancies according to the FDI criteria (p > 0.05). CONCLUSION: The clinical performance of the universal adhesive when applied in etch-and-rinse mode was not influenced by dentin moisture in posterior bulk-fill composite restorations. CLINICAL SIGNIFICANCE: The level of dentin moisture appears not to influence the clinical efficacy of a universal adhesive when applied using the etch-and-rinse technique in posterior composite resin restorations.

Clinical performance of preheating thermoviscous composite resin for non-carious cervical lesions restoration: A 24-month randomized clinical trial.

OBJECTIVES: This 24-month, double-blind, split-mouth randomized clinical trial aimed to compare the retention rates of a preheated thermoviscous composite resin (PHT) compared to a non-heated composite resin (NHT) in non-carious cervical lesions (NCCLs). METHODS: A total of 120 restorations were restored on NCCLs using a preheated (VisCalor bulk, Voco GmbH) and a non-heated (Admira Fusion, Voco GmbH) composite resins with 60 restorations per group. A universal adhesive in the selective enamel conditioning was applied. In the PHT group, composite was heated at 68 °C for using a bench heater. In the NHT group, no heating was employed. Both restorative materials were dispensed into caps and inserted into the NCCLs. The restorations were evaluated at baseline, 6, 12, 18, and after 24 months of clinical service using the FDI criteria. Statistical analysis was performed with Kaplan-Meier estimation analysis for retention/fracture rate and Chi-square test for the other FDI parameters (α=0.05). RESULTS: After 24 months 108 restorations were assessed. Seven restorations were lost (two for PHT group and five for NHT group), and the retention rates (95 % confidence interval [CI]) were 96.7 % (81.5-99.9) for PHT group and 90.8 % (81.1-96.0) for NHT group, with no statistical differences between them (p > 0.05). The hazard ratio (95 % CI) was 0.52 (0.27 to 1.01), with no significant difference within groups. In terms of all other FDI parameters that were assessed, all restorations were deemed clinically acceptable. CONCLUSIONS: Both composites showed high rates of retention rates after 24 months. CLINICAL SIGNIFICANCE: The clinical performance of the new preheated thermoviscous was found to be as good as the non-heated composite after 24-month of clinical evaluation in non-carious cervical lesions. REGISTRATION OF CLINICAL TRIALS: RBR-6d6gxxz.

Clinical evaluation of posterior restorations over wet and dry dentin using an etch-and-rinse adhesive: A 36-month randomized clinical trial.

OBJECTIVES: To evaluate the clinical performance of posterior restorations over wet and dry dentin with an etch-and-rinse adhesive after 36 months of clinical service. METHODS: Forty-five participants were recruited, each one had at least two posterior teeth that needed restoration. Ninety restorations were placed on Class I or Class II cavities. For the restoration protocol, a simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied over wet (WD) or dry dentin (DD) and later restored with a bulk-fill composite (Filtek Bulk Fill) under rubber dam isolation. Each restoration was evaluated using the World Dental Federation (FDI) criteria after 6, 12, and 36 months of clinical service, regarding the following principal restoration characteristics: postoperative sensitivity, marginal discoloration, marginal adaptation, fracture of material and retention, and recurrence of caries. Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used for statistical analysis. RESULTS: After 36 months of clinical evaluation, no significant difference between groups was observed in each FDI criterion (p > 0.05). Twenty restorations (WD=10, DD=10) showed minor marginal staining, and twenty-two restorations (WD=11, DD=11) presented small marginal adaptation defects (p > 0.05). Four restorations were lost (WD = 2, DD = 2) and the fracture rates (95% confidence interval) were 94.9% for each one, without significant difference between wet and dry dentin (p > 0.05). SIGNIFICANCE: The degree of dentin moisture does not seem to affect the clinical performance of a simplified etch-and-rinse adhesive in posterior restorations when the adhesive is applied vigorously over the dentine surface.

Prolonged polymerization of a universal adhesive in non-carious cervical lesions: 36-month double-blind randomized clinical trial.

OBJECTIVE: To evaluate the effect of prolonged (P) polymerization time of a universal adhesive system applied in etch-and-rinse (ER) or self-etch (SE) strategies on the clinical performance of restorations in non-carious cervical lesions (NCCLs), after 36 months of clinical service. METHODS: A total of 140 restorations were randomly placed in 35 subjects according to the polymerization time groups: ER (10 s); ER-P (40 s); SE (10 s); and SE-P (40 s) at 1,200 mW/cm2. Composite resin was placed incrementally. The restorations were evaluated immediately and after 6, 12, 18, and 36 months using the FDI criteria. Data were analyzed using the Kaplan-Meier survival test for retention loss, and the Kruskal-Wallis' test for secondary outcomes (α = 0.05). RESULTS: After 36 months, 19 restorations were lost: ER 6, ER-P 2, SE 9, SE-P 2. The retention rates were 82.3% for ER; 94.1 % for ER-P; 73.5 % for SE; and 94.1 % for SE-P, with a significant difference between ER vs. ER-P and SE vs. SE-P, as well as ER vs. SE-P and ER-P vs. SE (p < 0.0001). Minor defects were observed in 18 restorations for the marginal staining criteria: ER 5, ER-P 2, SE 8, SE-P 3; and in 33 restorations for the marginal adaptation criteria: ER 11, ER-P 4, SE 12, and SE-P 6 (p > 0.05). No restorations showed recurrence of caries or postoperative sensitivity. CONCLUSIONS: A prolonged polymerization time of 40 s improves the clinical performance of the universal adhesive for both adhesive strategies evaluated, even after 36 months. CLINICAL SIGNIFICANCE: Prolonging the polymerization time of a universal adhesive from 10 to 40 s has been shown to improve its clinical performance when used in NCCLs.

Influence of surface sealants on the quality of posterior restorations with bulk-fill composites: A 4-year randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years. METHODS: A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05). RESULTS: After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe). SIGNIFICANCE: Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.

5-year clinical performance of posterior bulk-filled resin composite restorations: A double-blind randomized controlled trial.

OBJECTIVES: The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). METHODS: Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). RESULTS: Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). SIGNIFICANCE: The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.

48-month clinical evaluation of a copper-containing universal adhesive in non-carious cervical lesions: A double-blind randomised clinical trial.

OBJECTIVES: This study aimed to evaluate the effect of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as an etch-and-rinse or self-etch strategy. METHODS: A total of 216 class V (non-carious lesions) restorations were randomly placed in 36 subjects according to the following groups: ERcu, adhesive in etch-and-rinse with 0.1% CuNp; ERct, adhesive in etch-and-rinse without CuNp; SEcu, adhesive in self-etch with 0.1% CuNp; and Sect, adhesive in self-etch without CuNp. Restorations were evaluated at baseline and at 6, 12, 18, 36, and 48 months, using the FDI and USPHS criteria. Appropriate statistical analyses were performed (α = 0.05). RESULTS: After 48 months, 14 restorations were lost (two for ERcu, five for SEcu, and seven for SEct) and the retention rates (95% confidence interval [CI]) were 74.1% for ERcu (95% CI 61.1-83.8); 81.5% for ERct (95% CI 69.2-89.6); 64.8% (95% CI 51.5-76.2) for SEcu; and 64.8% (95% CI 51.5-76.2) for SEct, with statistical differences between SEct vs. ERct and SEcu vs. ERct (p < 0.05). No significant differences between the groups were observed when the secondary parameters were evaluated (p > 0.05). Nineteen restorations (two for ERcu, two for ERct, six for SEcu, and nine for SEct) showed minor marginal staining, and 44 restorations (7 for ERcu, 8 for ERct, 14 for SEcu, and 15 for SEct) presented minimal marginal adaptation defects. SIGNIFICANCE: This is the first long-term clinical trial to show that the addition of CuNp to a universal adhesive system does not affect clinical performance.

Various ways of pre-heating a bulk-fill thermoviscous composite in restoration in non-carious cervical lesions: 12-month randomized clinical trial.

OBJECTIVE: The objective of the study is to evaluate through a randomized clinical trial the best method to preheat a composite resin, if using a Caps dispenser device associated with Caps Warmer (CD) or with a VisCalor Caps dispenser/warmer (VD) for restorations in non-carious cervical lesions (NCCLs). MATERIAL AND METHODS: One hundred and twenty restorations were distributed to two groups (n = 60) according to the pre-heating way of thermoviscous bulk-fill composite resin. For the CD group, pre-heating was carried at 68 °C using a heating bench for 3 min. For the VD group, pre-heating was performed at 68 °C using a heating gun for 30 s. After that, pre-heated bulk-fill composites were directly inserted in the NCCLs. The total working time was recorded. The restorations were evaluated after 6 and 12 months of clinical performance according to the FDI criteria. Statistical analysis was performed using the Student's t test for unpaired samples for working time, and the Chi-square test for restoration clinical performance (α = 0.05). RESULTS: Working time was shorter for VD with a statistically significant difference compared to CD (p = 0.01). Few restorations were lost or fractured after 12 months of clinical evaluation (p > 0.05). The retention rates were 96.7% (CI 95 %: 88.6-99.1%) for CD and 98.3% (CI 95 %: 91.1-99.7%) for VD. The other FDI parameters were considered clinically acceptable. CONCLUSIONS: The different pre-heating ways did not influence the clinical performance of thermoviscous bulk-fill composite restorations in NCCLs after 12 months. CLINICAL RELEVANCE: Regardless of the bulk-fill thermoviscous composite resin pre-heating ways, the restorations are clinically acceptable after 12 months.

Five-year clinical evaluation of universal adhesive applied following different bonding techniques: A randomized multicenter clinical trial.

OBJECTIVES: To evaluate the clinical performance of a universal adhesive system (Futurabond U, Voco) when applied following different adhesive strategies in non-carious cervical lesions (NCCLs) after 5 years. METHODS: Fifty participants were included. Futurabond U (Voco) was applied in NCCLs using four adhesive strategies (n = 50 each): only self-etch (SE); selective enamel etching + self-etch (SET + SE); etch-and-rinse with dry dentin (ERD); and etch-and-rinse with wet dentin (ERW). All cavities were restored with Admira Fusion composite resin (Voco). Restorations were evaluated after 1, 3, and 5 years using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. RESULTS: After 5 years, retention rates were 81 % (65.8-90.5) for SE, 87 % (73.2-94.4) for SET + SE, 84 % (69.6-92.6) for ERD, and 78 % (63.6-88.9) for ERW (p > 0.05). Thirty-five restorations were considered to have minor discrepancies in marginal adaptation at the 5-year recall (14 for SE, 9 for SET + SE, 6 for ERD, and 6 for ERW; p > 0.05). Sixteen restorations were detected as a minor marginal discoloration (6 for SE, 4 for SET + SE, 1 for ERD, and 5 for ERW; p > 0.05) and one restoration showed a recurrence of caries (1 for ERW; p > 0.05) at the 5-year recall. No restorations showed postoperative sensitivity after 5 years. SIGNIFICANCE: NCCLs restorations using a universal adhesive showed satisfactory clinical performance after 5 years, regardless of the adhesive strategy.

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial.

OBJECTIVES: This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. METHODOLOGY: A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. RESULTS: After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). CONCLUSION: Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

A 24-month clinical evaluation of composite resins with different viscosity and chemical compositions: a randomized clinical trial.

OBJECTIVES: To evaluate the clinical performance of two methacrylate-based flowable composites and an ormocer-based flowable composite in noncarious cervical lesions (NCCLs) in adult participants. METHOD AND MATERIALS: In total, 183 restorations were performed on NCCLs. All cavities were restored using a universal adhesive system (Futurabond U, Voco) with selective enamel etching and with one of the three evaluated flowable composites (n = 61): low-viscosity methacrylate-based composite (GrandioSO Flow, LV), high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 24 months. Kruskall-Wallis analysis of variance rank (α = .05) was used for statistical analysis. RESULTS: After 24 months of clinical evaluation, 16 restorations were lost (LV = 3, HV = 10, ORM = 3) and the retention rates (95% confidence interval) were 95.0% for LV, 82.2% for HV, and 95.0% for ORM, with statistical differences observed between HV and LV as well as HV and ORM (P < .05). When secondary parameters were evaluated, no significant differences between groups were observed (P > .05). Thirty-three restorations (LV = 8, HV = 13, ORM = 12) showed minor marginal staining, 71 restorations (LV = 26, HV = 20, ORM = 25) presented small marginal adaptation defects, and one restoration for HV presented recurrence of caries. CONCLUSION: The universal adhesive associated with the ormocer-based and methacrylate-based flowable composite showed promising clinical performance after 24 months. However, the heavy-flow restorations showed significantly more failures. (Quintessence Int 2023;54:186-199; doi: 10.3290/j.qi.b3631841).

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial

Abstract Objectives This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. Methodology A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. Results After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). Conclusion Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

A universal adhesive containing copper nanoparticles improves the stability of hybrid layer in a cariogenic oral environment: An in situ study.

PURPOSE: To evaluate how incorporating copper nanoparticles (CuNp) into a universal adhesive affects the antimicrobial activity (AMA), bond strength (µTBS), nanoleakage (NL), elastic modulus (EM) and nanohardness (NH) of resin-dentin interfaces, at 24 h (24 h) and after in situ cariogenic challenge (CC). METHODS: CuNp (0% [control] and 0.1 wt%) was added to an adhesive. After enamel removal, the adhesives were applied to dentine surfaces. Each restored tooth was sectioned longitudinally to obtain two hemi-teeth; one of them was evaluated after 24 h, and the other was included in one of the intra-oral palatal devices placed in the mouths of 10 volunteers for 14 days in CC. After that, each hemi-tooth was removed, and any oral biofilm that formed was collected. The AMA was evaluated against Streptococcus mutans. For the 24 h and CC groups, each hemi-tooth was sectioned in the "x" direction to obtain one slice for each EM/NH evaluation. The remains of each hemi-tooth were sectioned in the "x" and "y" directions to obtain resin-dentin beams for µTBS and NL evaluation (24 h and CC). ANOVA and Tukey's test were applied (α = 0.05). RESULTS: The presence of CuNp significantly improved AMA as well as all of the evaluated properties (24 h; p < 0.05). Although the adhesive properties (µTBS/NL) for all groups decreased after CC (p < 0.05), the adhesive containing CuNp showed higher µTBS and lower NL as compared to the copper-free adhesive (p < 0.05). The incorporation of CuNp maintained NH/EM values after CC (p < 0.05). CONCLUSIONS: Adding 0.1% CuNp to an adhesive may provide antimicrobial activity and increase its bonding and mechanical properties, even under a cariogenic challenge. SIGNIFICANCE: This is the first in situ study proving that incorporating CuNp into an adhesive is an achievable alternative to provide antimicrobial properties and improve the integrity of the hybrid layer under in situ cariogenic challenge.

A new preheating thermoviscous composite for restoration of non-carious cervical lesions: a 6-month randomized clinical trial / Um novo compósito termoviscoso de pré-aquecimento para restauração de lesões cervicais não cariosas: ensaio clínico randomizado de 6 meses

Objetivo: Este ensaio clínico randomizado, duplo-cego e boca dividida avaliou o desempenho clínico de um novo compósito termoviscoso com pré-aquecimento (PHT) em comparação com uma resina composta sem aquecimento (NHT) em restaurações de lesões cervicais não cariosas (LCNCs) durante um período de 6 meses. Material e Métodos: 120 restaurações foram realizadas em LCNCs com dois materiais restauradores (n = 60). Após a profilaxia, os dentes foram isolados com isolamento de fio retrator/rolos de algodão e um adesivo universal foi aplicado na estratégia de condicionamento seletivo do esmalte. Para o grupo PHT o aquecimento foi realizado a 68°C usando um aquecidor de bancada por 3 min. Por outro lado, para o grupo NHT, nenhum aquecimento foi aplicado. Ambos os materiais restauradores foram colocados no dispensador de cápsulas e inseridos nas LCNCs. Após 6 meses, o desempenho clínico das restaurações foi avaliado de acordo com os critérios FDI. A análise estatística foi realizada com teste Qui-quadrado para todos parâmetros da FDI (α = 0,05). Resultados: Apenas três restaurações no grupo NHT foram perdidas/fraturadas após seis meses de acompanhamento. As taxas de retenção (intervalo confiança 95%) por seis meses foram de 97,5% (88,6% - 99,0%) para o grupo NHT e 100% (93,9% - 100%) para o grupo PHT (p > 0,05). Vinte e duas restaurações (8 para NHT e 14 para PHT) apresentaram pequenos defeitos de adaptação marginal aos seis meses de acompanhamento (p > 0,05). Vinte e seis restaurações apresentaram alguma retenção de biofilme aos seis meses de acompanhamento (11 para NHT e 15 para PHT; p > 0,05). Em relação a todos os outros parâmetros de FDI avaliados, todas as restaurações foram consideradas clinicamente aceitáveis. Conclusão: O desempenho clínico do novo compósito termoviscoso de pré-aquecimento mostrou-se promissor após 6 meses de avaliação clínica quando aplicado em LCNCs.(AU)

Objective: This double-blind, split-mouth randomized clinical trial evaluate the clinical performance of a new preheating (PHT) thermoviscous composite compared to a non-heating (NHT) composite resin in restorations of non-carious cervical lesions (NCCLs) over a period of 6-month. Material and Methods: 120 restorations were performed on NCCLs with two restorative materials (n = 60). After prophylaxis, the teeth were isolated with retraction cord isolation/cotton rolls and one universal adhesive was applied in the selective enamel etching strategy. For the PHT group heating was carried out at 68°C using a heater bench for 3 min. On the other side, for the NHT group, no heating was applied. Both restorative materials were placed in the caps dispenser and inserted in the NCCLs. The restorations were evaluated after 6-month of clinical performance according to the FDI criteria. Statistical analysis was performed with Chi-square test for all FDI parameters (α = 0.05). Results: Three restorations only in the NHT group were lost/fractured after six months follow-up. The retention rates (confidential interval 95%) for six months were 97.5% (88.6% - 99.0%) for the NHT group and 100% (93.9% - 100%) for the PHT group (p > 0.05). Twenty-two restorations (8 for NHT and 14 for PHT) presented small marginal adaptation defects at the six-months follow-up (p > 0.05). Twenty-six restorations were found to have biofilm retention in the six-month recall (11 for NHT and 15 for PHT; p > 0.05). Regarding all others FDI parameters evaluated, all restorations were considered clinically acceptable. Conclusion: The clinical performance of the new preheating thermoviscous was found to be promise after 6-month of clinical evaluation when applied in NCCLs (AU)

Protección pulpar: cementos a base de silicato de calcio. Relato de un caso clínico / Pulp capping: calcium silicate-based cements. Report of a clinical case

RESUMEN Los cementos a base de silicato de calcio son materiales bioactivos, que poseen la capacidad de liberar mayor cantidad de iones de calcio e hidroxilo, brindando ciertas ventajas como mayor capacidad antimicrobiana y de remineralización, incrementando la longevidad de los tratamientos pulpares. Theracal LC es un cemento a base de silicato de calcio el cual tiene como ventaja su presentación de fácil aplicación a comparación de otros cementos bioactivos. En el presente reporte de caso, Theracal LC fue utilizado como forro cavitario. Al examen clínico el paciente presentó las piezas 36 y 35 con el diagnóstico dental: caries dental con lesión con cavidad y caries dental con lesión profunda adyacente a restauración, respectivamente y como diagnóstico pulpar: Pulpa sana, en ambas piezas. Se realizaron restauraciones directas con resina compuesta en las piezas 36 y 35, considerando los siguientes pasos: grabado selectivo, sistema adhesivo autocondicionante, cemento protector a base de silicato de calcio y resina compuesta para técnica Bulk.

SUMMARY Calcium silicate-based cements are bioactive materials, which have the capacity to release a greater number of calcium and hydroxyl ions, providing some advantages like an increased antimicrobial and remineralise activity, increasing the pulp treatments longevity. Theracal LC is a calcium silicate-based cement that has as an advantage its easy application, comparing to others bioactive cements. In this case report, Theralcal LC was used as a cavity liner. At clinical examination teeth 36 and 35 exhibited diagnosis of Dental caries; 36 with a cavitated lesion and 35 with a lesion adjacent to a previous restoration; and pulp diagnosis, Sound Pulp, for both tooth pieces. Direct restorations were made with composite resin in tooth pieces 36 and 35, considering the following steps: selective etching, self-etch adhesive system, calcium silicate-based cement and Bulk-fill resin composite.

Effect of the manual manipulation of composite resin with latex gloves / Efecto de la manipulación manual de resina compuesta con guantes de látex

Purpose: This in vitro study aimed to evaluate the influence of the manual manipulation of two composite resins: Filtek™ Z350XT (3M ESPE) and Herculite Précis® (Kerr), with latex gloves contaminated with powder, human saliva and alcohol, on the microhardness values. Material and Methods: Manual manipulation was evaluated using latex gloves with powder, latex gloves without powder, latex gloves without powder with saliva, latex gloves without powder with alcohol, and without hand manipulation or contaminants (control). Each resin was manually manipulated for 10 seconds and photoactivated for 20 seconds with a light intensity of 1000mW/cm2 using a VALO ­Ultradent LED light­ cured unit, and then each sample was evaluated on the microhardness Vickers tester Leitz (Wetzlar). The collected data were analyzed using Kruskal ­Wallis and Mann ­ Whitney post-test (p<0.05). Results. Microhardness values showed a significant difference between the evaluated and control groups, showing lower microhardness values in the group of latex glove with powder for Filtek™ Z350XT and the group of latex glove without powder with saliva for Herculite Précis®. Conclusion. The manual manipulation of composite resins decreases their surface microhardness.

Propósito: Este estudio in vitrotuvo como objetivo evaluar la influencia de la manipulación manual de dos resinas compuestas: Filtek ™ Z350XT (3M ESPE) y Herculite Précis® (Kerr), con guantes de látex contaminados con polvo, saliva humana y alcohol, sobre los valores de microdureza. Material y Métodos: La manipulación manual se evaluó utilizando guantes de látex con polvo, guantes de látex sin polvo, guantes de látex sin polvo con saliva, guantes de látex sin polvo con alcohol, y sin manipulación manual o contaminantes (control). Cada resina fue manipulada manualmente durante 10 segundos y fotoactivada durante 20 segundos con unaintensidad de luz de 1000mW/cm2 usando una unidad de fotocuración LED VALO - Ultradent, y luego cada muestra fue evaluada en el tester de microdureza Vickers Leitz (Wetzlar). Los datos recopilados se analizaron utilizando Kruska ­Wallis y post-test Mann­ Whitney (p<0.05). Resultados: Se observó una diferencia significativa en los valores de microdureza entre los grupos evaluados y el grupo control, con valores más bajos de microdureza en el grupo de guantes de látex con polvo para Filtek™ Z350XT y el grupo de guantes de látex sin polvo con saliva para Herculite Précis®. Conclusión. La manipulación manual de resinas compuestas disminuye su microdureza superficial.