Efeito de diferentes sistemas de polimento na rugosidade superficial e brilho de resina composta: análise clínica e laboratorial / Effect of different polishing systems on the surface roughness and gloss of resin composite: Clinical and in vitro analysis

Este trabalho foi composto por dois estudos: um in vitro e um clínico randomizado e duplo-cego. O objetivo deste estudo foi compreender o efeito de diferentes sistemas de polimento na rugosidade e brilho superficial da resina composta avaliados em diferentes períodos. Estudo Laboratorial: Cinquenta espécimes de resina composta (Amaris, VOCO) foram confeccionados e divididos em dois grupos variando o sistema de polimento utilizado SFE: Sof-Lex Espiral (3M ESPE) - dois passos e DMT: Dimanto (VOCO) - passo único. Análises de brilho espectral, brilho subjetivo e rugosidade superficial foram realizadas, imediatamente após o polimento, após seis meses e após um ano. O teste de Kolmogorov-Smirnov foi utilizado para verificar a normalidade dos dados. Para o brilho espectral foi utilizada análise de variância de medidas repetidas (ANOVA)(p<0,05) seguida do teste de Tukey (α = 0,05) que demonstraram que o grupo SFE apresentou maior brilho e ainda, ambos os grupos obtiveram valores de brilho menores após seis meses. Como os dados de brilho subjetivo e rugosidade superficial não apresentaram normalidade, foram aplicados os testes Mann-Whitney U e Frideman (α = 0,05). Para o brilho subjetivo, SFE apresentou maiores valores do que DMT quando avaliado após o polimento, porém, em seis e doze meses não houve diferença estatisticamente significante entre eles. Quanto a rugosidade superficial não houve diferenças significantes entre os dois sistemas de polimento nem quanto a fator tempo e nem na interação desses fatores. Estudo Clínico: Cinquenta facetas em resina composta (Amaris, VOCO) foram realizadas em pacientes e divididas em dois grupos, dependendo do sistema de polimento utilizado e avaliadas quanto a brilho subjetivo por pacientes e examinadores, quanto a rugosidade superficial em rugosímetro através de réplicas em resina epoxi e pelo paciente através da Escala Análoga Visual (EAV) e percepção pela língua comparando a um dente natural (controle), após o polimento e após seis meses. Os resultados foram submetidos à análise estatística para verificar a normalidade dos dados. Para a analise com EAV não foi encontrada diferença estatística. Para a percepção da textura da superfície, não houve diferença após o polimento, demonstrado pelos testes Exato de Fischer e Qui-Quadrado. Após seis meses o grupo DMT percebeu diferença de rugosidade, onde os pacientes consideraram o dente da faceta mais liso. Em relação a percepção de brilho pelo paciente, o teste Qui-quadrado demonstrou que não houve diferença entre os grupos. Quanto a avaliação pelo profissional, os testes de Mann-Whiteney e Wilcoxon demonstraram que para o grupo após o polimento, sistema DMT apresentou maiores valores de brilho do que SFE e ambos perderam brilho após seis meses. Quanto a rugosidade os testes de Mann-Whiteney e Wilcoxon demonstraram que o grupo DMT apresentou menores valores enquanto SFE apresentou maiores valores em seis meses. Os resultados da avaliação subjetiva realizada pelos profissionais foram bem próximos a dos pacientes, sendo uma alternativa para avaliação da satisfação do paciente com o tratamento recebido(AU)

This research was composed of two studies: an in vitro and a double-blind randomized clinical study. The aim of the research was to understand the effect of different polishing systems on the surface roughness and gloss of resin composite measured in different periods of time. In vitro study: Fifty specimens of composite resin (Amaris, VOCO) were made and divided into two groups according to the polishing system used SFE: Sof-Lex Spiral (3M ESPE) - two steps and DMT: Dimanto (VOCO) - single step. Spectral and subjective gloss and surface roughness analysis were performed at baseline (right after polishing), after six and twelve months. The Kolmogorov-Smirnov test was used to verify the normality of the data. For spectral gloss analysis repeatedmeasures (ANOVA) followed by Tukey´s test (α = 0.05) demonstrated that SFE presents higher values than DMT and both groups obtained higher values of gloss right after polishing than after six months. As the subjective data of gloss and roughness did not present normal distribution, Mann-Whitney and Friedman tests were applied for statistical analysis (α = 0.05). SFE group presented higher values of subjective gloss than DMT just right after polishing, however for other periods evaluated, there was no statistically significant difference. Regarding the surface roughness, there were no significant differences between the two groups evaluated, neither in terms of time, nor for the interaction time and polishing systems. Clinical Study: Fifty composite veneers (Amaris, VOCO) were made on patients and divided into two groups, according to the polishing systems used and assessed for subjective gloss obtained by patients and by examiners evaluation, surface roughness measured using a profilometer and veneer epoxi resin replicas and by patients with Visual Analogue Guide (VAG) and texture perception by the tongue comparing a natural tooth (control) right after polishing and after six months. The results were submitted to statistical analysis to verify the normal distribution of the data. For the surface roughness evaluated by the patients with the VAG no statistical differences were found. For the surface texture perception, patients were not able to identify differences right after the polishing as demonstrate by Fischer Exact and Chi-Square tests, however, after six months DMT group reported differences where natural teeth were consider rougher than the veneers. Regarding the perception of gloss by the patient, the Chi-Square test showed no difference between the groups. However, some patients of DMT group described the veneers glossier than the natural tooth. For the subjective gloss assessed by the professional, the Mann-Whitney and Wilcoxon tests demonstrated that DMT system showed higher values of gloss than SFE right after polishing and at six-month evaluation both groups demonstrated lower values of gloss. For roughness, the Mann-Whitney and Wilcoxon tests showed that the DMT group had lower values of surface roughness and SFE group showed an increase after six months evaluation. The results of the subjective assessment made by professionals were close to that made by patients and was an alternative to evaluate patient satisfaction with the treatment received(AU)

Evaluation of root roughness after using diamond tips, ultrasound tips, and hand curettes in human teeth, in vitro study / Avaliação da rugosidade radicular utilizando pontas diamantadas, pontas ultrassônicas e curetas manuais em dentes humanos, estudo in vitro

This in vitro study aimed to compare the degree of root roughness in human teeth treated after using hand curettes, stainless steel, and diamond ultra sound tips. Material and Methods: The scaling was performed on the root surface of 36 human teeth previously standardized and randomly divided in to three groups (n=12). The roughness degree was measured with the aid of a rugosimeter, before and after thes caling, through readings perpendicular and parallel to the scaling direction. The statistical analysis comprised Wilcoxon and Kruskal-Wallis tests (p<0.05). The qualitative and visual complementation of the results was performedby scanning electronic microscopy. Results: The scaling executed with hand curettes increased root roughness (before - Ra median=0.1583μm;after =0.7783μm; before - Rz median =1.667μm; after=7.350μm). The degree of root roughness also increased when stainless steel ultrasound (before - Ra median= 0.1483 μm;after=0.3933 μm; before- Rz median=1.567 μm;after=4.333 μm) and diamond tips were used(before - Ra median=0.1800 μm; after=2.457μm; before - Rz median=1.850 μm; after=18.58μm). Conclusion: The superficial roughness significantly increased in all groups. The scalingwith diamond tips promoted the greatest rootroughness than hand curettes and ultrasoundtips...

O objetivo deste estudo in vitro foi avaliar e comparar o grau de rugosidade radicular em dentes humanos tratados com curetas manuais, pontas ultrassônicas de aço-inox e pontas diamantadas. Materiais e Métodos: A instrumentação foi realizada sobre a superfície radicular de 36 dentes humanos previamente padronizados e divididos aleatoriamente em três grupos (n = 12). O grau de rugosidade foi mensurado, em rugosímetro, antes a após a instrumentação, através de leituras perpendiculares e paralelas ao sentido da instrumentação. Na análise estatística foram utilizados os Testes de Wilcoxon e Kruskal-Wallis (p < 0,05). Para avaliação qualitativa e complementação visual dos resultados foi realizada microscopia eletrônica de varredura. Resultados: A instrumentação realizada com curetas manuais provocou aumento da rugosidade radicular (mediana de Ra antes= 0,1583 μm/depois = 0,7783 μm; mediana de Rz antes= 1,667 μm/depois = 7,350 μm). O grau de rugosidade radicular também aumentou quando se utilizou ponta sultrassônicas de aço-inox (mediana de Ra antes= 0.1483μm/depois = 0,3933 μm; mediana de Rz antes = 1,567μm/depois = 4,333 μm) e pontas diamantadas (mediana de Ra antes = 0,1800 μm/depois = 2,457 μm; mediana de Rz antes = 1,850 μm/depois = 18,58 μm). Conclusão:Houve aumento significativo da rugosidade superficial em todos os grupos. A instrumentação realizada com pontas diamantadas provocou maior aumento da rugosidade radicular quando comparada com o uso de curetas manuais e pontas ultrassônicas...

Microtensile bond strength of a resin cement to feldpathic ceramic after different etching and silanization regimens in dry and aged conditions.

OBJECTIVES: This study evaluated the durability of bond strength between resin cement and a feldspathic ceramic submitted to different etching regimens with and without silane coupling agent application. METHODS: Thirty-two blocks (6.4 mm x 6.4 mm x 4.8 mm) were fabricated using a microparticulate feldspathic ceramic (Vita VM7), ultrasonically cleaned with water for 5 min and randomly divided into four groups, according to the type of etching agent and silanization method: method 1, etching with 10% hydrofluoric (HF) acid gel for 1 min + silanization; method 2, HF only; method 3, etching with 1.23% acidulated phosphate fluoride (APF) for 5 min + silanization; method 4, APF only. Conditioned blocks were positioned in their individual silicone molds and resin cement (Panavia F) was applied on the treated surfaces. Specimens were stored in distilled water (37 degrees C) for 24h prior to sectioning. After sectioning the ceramic-cement blocks in x- and y-axis with a bonded area of approximately 0.6mm(2), the microsticks of each block were randomly divided into two storage conditions: Dry, immediate testing; TC, thermal cycling (12,000 times)+water storage for 150 d, yielding to eight experimental groups. Microtensile bond strength tests were performed in universal testing machine (cross-head speed: 1mm/min) and failure types were noted. Data obtained (MPa) were analyzed with three-way ANOVA and Tukey's test (alpha=0.05). RESULTS: Significant influence of the use of silane (p<0.0001), storage conditions (p=0.0013) and surface treatment were observed (p=0.0014). The highest bond strengths were achieved in both dry and thermocycled conditions when the ceramics were etched with HF acid gel and silanized (17.4 +/- 5.8 and 17.4 +/- 4.8 MPa, respectively). Silanization after HF acid gel and APF treatment increased the results dramatically (14.5+/-4.2-17.4+/-4.8 MPa) compared to non-silanized groups (2.6 +/- 0.8-8.9 +/- 3.1 MPa) where the failure type was exclusively (100%) adhesive between the cement and the ceramic. SIGNIFICANCE: Silanization of the feldspathic ceramic surface after APF or HF acid etching increased the microtensile bond strength results significantly, with the latter providing higher results. Long-term thermocycling and water storage did not decrease the results in silanized groups.