ABSTRACT
Bioactive materials have emerged as a promising alternative to conventional restorative materials as part of more conservative dentistry. The aim of this study was to evaluate and compare the shear bond strength (SBS) and microleakage of a new bioactive restorative material, two bulk-fill restorative composites, and a conventional composite at 24 h, 4 weeks, and 8 weeks. Three hundred and sixty molars and premolars were divided into four groups: ACTIVA™ BioACTIVE Restorative™, Filtek™ Bulk-Fill Restorative Composite, Tetric® N-Ceram Bulk-Fill Composite, and G-aenial® Composite. The normality of the data was determined with the Kolmogorov-Smirnov test, then the two-way ANOVA and Fisher's test were used for analyzing SBS data, and the Kruskal-Wallis and DSCF tests were conducted to analyze the microleakage. In the SBS test, there were no statistically significant differences between materials (p = 0.587), and the relation between material and time (p = 0.467), time points showed statistically significant differences (p = 0.016). As for the microleakage, statistically significant differences were found for all three time periods (p < 0.05), showing the conventional composite to have the lowest microleakage, followed by the bioactive material, and lastly the two bulk-fill composites. In conclusion, the new bioactive material has similar evaluated properties to bulk-fill composites (bond strength) and conventional composites (bond strength and microleakage) and can be used as an alternative restorative material.
ABSTRACT
La perdida de un diente en la zona estética anterior y su reemplazo con una restauración implanto soportada representa uno de los mayores desafíos estéticos y funciónales en el campo de la Implantología moderna.La evidencia actual respalda la provisionalización inmediata de un implante después de su inserción con tasas de éxito comparables con las de los protocolos tradicionales utilizados recientemente. Siegenthaler y col, concluyeron que para aquellos implantes donde se alcanzó estabilidad primaria, la colocación de implantes inmediatos en alvéolos postextracción que presentaban lesiones periapicales no conllevó a un aumento en la tasa de complicaciones y resultó en una integración igualmente favorable en comparación con el grupo control. La adecuada selección del caso para este tipo de protocolos es fundamental y debe estar regido por una filosofía clara de Preservación. La preservación de las estructuras orales existentes en el área a intervenir exige un enfoque terapéutico netamente conservador que favorezca un resultado final favorable y exitoso. La paciente tratada es una de 40 años de edad que acude al postgrado de rehabilitación oral de la Universidad CES de Medellín, Colombia cuyo motivo de consulta fue "Para revisión recomendada por periodoncia" según sus propias palabras. Al momento del examen clínico intraoral se observó encía edematizada a nivel de #11 con profundad al sondaje de 10 mm en DP sospechando una fractura vertical que se corroboró con el análisis de la radiografía periapical. Se le planteó claramente a la paciente las distintas opciones de tratamiento por la pérdida del incisivo central superior con las posibles complicaciones y riesgos que se podrían presentar. La paciente aceptó la opción del implante inmediato postextracción con provisionalización y procedió a firmar el consentimiento informado de la historia clínica. Conclusiones: La provisionalización inmediata del implante brinda beneficios adicionales para la integración de los tejidos blandos, ofreciendo unos resultados estéticos de alta calidad. La colocación de implantes inmediatos en alvéolos con procesos infecciosos periapicales tiene un porcentaje de éxito prometedor a corto plazo.
The lost of an anterior tooth and it replacement with a retained implant restoration is one of the mayor functional and aesthetic challenges in modern implantogy. Actual Evidence support that immediate implant provisionalization compare with the traditional protocols have similar results in success rates. Siegenthaler y col conclude that in situations when the primary stabilization is obtained, the implant placement in fresh sockets with cronical periapical lesions have similar results versus control group. Carefull must be taken in the case selection for this modern protocol and should be done under the preservation philosophy. The integrity of remaining bone structures and soft tissue is the main goal for the success of this technique. Female patient, 40 years old, who attended the program of oral rehabilitation at the University of CES Medellin, Colombia, whose reason for consultation was "To review recommended by periodontics" in his own words. At the time of clinical examination intraoral gum edema was observed at # 11 with probing 10 mm in DP suspecting a vertical fracture who was corroborated with the analysis of the periapical X-ray. The different treatment options were stated clearly to the patient for the loss of the maxillary central incisor with the possible complications and risks that could arise. The patient agreed to the immediate post-extraction implant option with temporization and proceeded to sign the informed consent of the medical record. Conclusions: The placement of implants immediate with infectious processes periapicals has a success rate in the short term very promising. The immediate provisionalization implant provides additional benefits for the integration of soft tissues, offering some high-quality aesthetic results.
