Adapted Three-step Restorative Technique: Recovering Dental Substrate Compromised by Complex Erosive Wear in a Young Patient.

CLINICAL RELEVANCE: This article presents the dental restoration of a young female patient complaining of erosive dental wear using a three-step restorative technique, an alternative approach with some novel adjustments. SUMMARY: For successful tooth wear treatment, determining the etiological systemic and local factors is the main priority before deciding on effective and long-term preventive and/or therapeutic restorative approaches. In addition to professional intervention, achieving optimal outcomes requires patients to control their diet and/or gastric issues, thus minimizing the wear process. However, continuous wear constitutes the most challenging scenario, mainly when it affects young patients' dentitions. This article describes the dental restoration of posterior teeth with reestablishment of occlusal vertical dimension before treating the anterior teeth, while educating the patient and providing medical monitoring. The three-step restorative technique seems to be properly applicable in cases of significant dental compromise due mainly to erosive wear and is based on direct procedures, which can assure a reliable and feasible approach.

Effect of conventional and resin-modified glass-ionomer liner on dentin adhesive interface of Class I cavity walls after thermocycling.

OBJECTIVE: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling. MATERIALS AND METHODS: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5°C-55°C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 mm × 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p<0.05). RESULTS: There was no detectedstatistical difference on bond strength among groups (α<0.05). Confocal microscopy analysis showed a higher mean gap size in group 4 (12.5 µm) and a higher percentage of marginal gaps in the thermocycled groups. The RMGIC liner groups showed the lowest percentage of marginal gaps. CONCLUSIONS: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Effect of adhesive systems associated with resin-modified glass ionomer cements.

The bonding of resin-modified glass ionomer cements to dentin remains a challenge in clinical routine. In an attempt to improve this property, different materials and techniques have been proposed. This study investigated the shear bond strength of resin-modified glass ionomer cements (Vitremer, 3M/ESPE and Fuji II LC Improved, GC) to human dentin using two one-bottle adhesive systems (Prime & Bond 2.1, Dentsply and Single Bond, 3M/ESPE). The restored specimens were stored in deionized water for 24 h at 37 +/- 1 degrees C, and then the bonded surfaces were tested in shear strength using a Universal testing machine at a crosshead speed of 0.5 mm min(-1). Bond strength means were recorded and failure modes were assessed with a stereomicroscope at 40x magnification. Data were submitted to two-way anova and multiple comparisons were performed using a Tukey statistical test (P < 0.05). Fuji II LC Improved yielded higher bond strength (P < 0.05) than Vitremer in all experimental conditions. No statistically significant differences (P > 0.05) were observed among the proposed dentin surface treatments, although a slight decrease in bond strength was observed when phosphoric acid was used alone. Bond strengths of the resin-modified glass ionomer cements to dentin seemed to be more material-dependent than surface treatment-dependent. It may be concluded that the one-bottle adhesive systems tested in this study did not improve the bond strength of the resin-modified glass ionomer cements to dentin.