Thirty-six-month follow-up of cervical composite restorations placed with an MDP-free universal adhesive system using different adhesive protocols: a randomized clinical trial.

OBJECTIVES: To evaluate the influence of different application strategies on the clinical behavior of an MDP-free universal adhesive placed in non-carious cervical lesions (NCCLs) over the course of 36 months. MATERIALS AND METHODS: Thirty-one patients participated in this study (N = 31). One hundred twenty-four restorations were assigned to four groups: We used the self-etch strategy on groups with (SE-et) and without (SET) selective enamel etching, and the etch-and-rinse strategy on groups with dry (ER-D) and moist (ER-M) dentin. After applying the MDP-free universal adhesive (Xeno Select universal adhesive, Dentsply Sirona), cavities were filled using EvoluX composite resin (Dentsply Sirona). The restorations were evaluated at baseline and after 36 months according to World Dental Federation (FDI) and US Public Health Service (USPHS) criteria. Friedman's repeated-measures analysis of variance rank (α = 0.05) was used for statistical analysis. RESULTS: We evaluated the 31 patients after 36 months. Forty-two restorations were lost (ER-D = 5, ER-M = 7, SE-et = 14, SET = 16). The 36-month retention/fracture rates (95% confidence interval) were 83.9% for ER-D, 77.4% for ER-M, 54.9% for SE-et, and 48.4% for SET. ER strategy showed better retention rate than SE strategy (p < 0.05). Thirty-four restorations (ER-D = 6, ER-M = 10, SE-et = 10, SET = 8) showed marginal staining per FDI criteria and 15 restorations (ER-D = 1, ER-M = 2, SE-et = 6, SET = 6) showed marginal staining per USPHS criteria. No restorations showed postoperative sensitivity or recurrence of caries. CONCLUSION: The retention rate of Xeno Select universal adhesive was poor, mainly in the self-etch strategy. TRIAL REGISTRATION: REBEC clinical registry under protocol RBR-4wh4sh. CLINICAL RELEVANCE: MDP-free universal adhesive behavior depends on the bonding strategy used.

Influence of simplified, higher-concentrated sodium ascorbate application protocols on bond strength of bleached enamel.

BACKGROUND: Bleaching procedures performed before restorative procedures, due to the oxygen released, affects the quality of bonding restorations. The application of an lower-concentrated antioxidant for one-hour or more can reversal the compromised bonding to bleached enamel, but it was not effective according to the bleaching concentrations applied. The aim of the present study was to evaluate simplified protocol of higher-concentrated sodium ascorbate (35%SA) in bond strength values of enamel bleached with 10%, 16%, 22% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). MATERIAL AND METHODS: Three hundred and forty enamel surfaces of 85 human third molars were used, divided into 17 groups (n=20), according to the following groups: control = no bleaching and no ascorbic acid application; bleaching (CP10%, CP16%, CP22% at-home and HP 35% in-office) and 35%SA application (no application; 35%SA applied twice for 1-min each [SA2×1], twice for 5-min each [SA2×5] and; twice for 10-min each [SA2×10]). After that, adhesive was applied and composite cylinders were made with Filtek Z350 composite. Microshear test was performed in a universal testing machine. BS values were statistically evaluated using ANOVA and Tukey's and Dunnet's (against control) tests, with 5% level of significance. RESULTS: All bleaching concentrations significantly decrease the enamel bond strength results when compared to control group (p<0.05). More concentrated PC (PC22% and PH35%) showed lower enamel bond strength results when compared to lower concentrated PC (PC10% and PC16%; p<0.05). A significant increase of the enamel bond strength results were only observed when SA2×5 and SA2×10 were applied (p<0.05). CONCLUSIONS: The application of 35% sodium ascorbate for twice 5- and 10-min each was an efficient protocol to reverse the bond strength in bleached enamel at the same level as the no bleaching enamel, independently of the bleaching concentration used. Key words:Tooth bleaching, hydrogen peroxide, sodium ascorbate, bond strength.

Análise da capacidade de remoção de pigmentos da resina composta pelo peróxido de hidrogênio 35% / Capacity analysis of pigment removal of composite resin by hydrogen peroxide 35%

Objetivo: Avaliar in vitro a capacidade de remoção de pigmentos ocasionados em resina composta após aplicação de peróxido de hidrogênio 35%. Material e método: Confeccionaram-se 20 amostras de resina composta Opallis (FGM), cor A1, em matriz metálica circular. As amostras foram divididas em quatro grupos (n=5) dos seguintes agentes corantes: água destilada (controle), café, vinho tinto e Coca-Cola®. No manchamento, as amostras ficaram imersas nas soluções durante 72 horas, com troca diária das bebidas. Procedeu-se à aplicação do gel de peróxido de hidrogênio 35% (Whiteness HP Blue Calcium, FGM) em três sessões, sendo uma aplicação do gel por sessão, o qual permaneceu nas amostras durante 40 minutos. Medidas de cor foram feitas inicialmente, após manchamento, após aplicação do peróxido e por mais 21 dias, usando espectrofotômetro Vita Easyshade. Os dados foram submetidos à análise de variância de dois fatores (tempo vs. corante) e ao teste de Tukey, para o contraste das médias (alfa=0,05). Resultado: Apresentaram alteração de cor (delta E - média/desvio padrão de L*) o café (15,7 ± 2,0) e o vinho (15,2 ± 4,6), quando comparados à Coca-Cola® (4,8 ± 1,9). O peróxido de hidrogênio removeu a pigmentação das amostras, porém, para nenhum dos corantes, houve retorno à coloração inicial, principalmente no grupo manchado por café (12,9 ± 1,5); este mostrou diferença significativa quando comparado ao controle (1,6 ± 0,6), diferentemente do vinho (3,3 ± 0,6) e da Coca-Cola® (2,1 ± 0,9), que se aproximaram do grupo controle. Conclusão: As soluções corantes pigmentaram a resina composta, principalmente o café. A aplicação do peróxido de hidrogênio 35% foi eficaz na remoção de pigmentos das amostras, porém, em nenhum dos grupos, com diferentes corantes, houve retorno à coloração inicial (p> 0,005).

Objective: Evaluate in vitro the ability to removal pigments of composite resin after application of hydrogen peroxide 35%. Material and method: Concocted to-20 resin samples composed Opallis (FGM), A1 color, in circular metal matrix. The samples were divided into 4 groups (n = 5) the following coloring agents: distilled water (control), coffee, red wine and Coca-Cola®. In the staining, the samples were immersed in the solutions for 72 hours, with daily change of beverages. Proceeded to the application of 35% hydrogen peroxide gel (Whiteness HP Blue Calcium, FGM) in 3 sessions, one application of gel per session that remained in the samples for 40 minutes. Color measurements were made initially after staining after application of the peroxide and for 21 days using Vita Easyshade spectrophotometer. The data were submitted to two-way ANOVA and Tukey's test (alfa = 0.05). Result: Significant color change was observed in specimens after immersion in the solutions, except the control group. Hydrogen peroxide was capable of removing the stains, however the color did not return to the baseline in any of the staining groups, especially for the groups immersed in coffee. Conclusion: Staining solutions can stain the composite resin. The application of 35% hydrogen peroxide can remove partially the staining, minimizing the color change produced by the staining solutions. However, the bleaching gel was not capable of removing all staining, especially for the coffee group.

Avaliação de cor da resina composta após manchamento com café solúvel, vinho tinto e Coca-Cola® seguido de clareamento dental / Color resin assessment made after staining with soluble coffee, red wine and Coke® followed by dental bleaching

O objetivo desse estudo in vitro foi avaliar a alteração de cor da resina composta (RC) submetida à pigmentação pelo café solúvel, vinho tinto e Coca-Cola®, bem como a alteração após o clareamento dental com peróxido de carbamida (PC) 16%. Foram confeccionados vinte espécimes de RC na cor A1 (Opallis, FGM) e aleatorizados em quatro grupos (n=5), de acordo com as soluções corantes: café solúvel, Coca-Cola®, vinho tinto e água destilada (controle). A cor inicial dos corpos de prova foi mensurada com espectrofotômetro Vita Easyshade e, em seguida, iniciou-se o processo de manchamento com as soluções corantes durante 72h. Após, foi realizado clareamento caseiro com PC 16%, por 3h diárias durante três semanas. A cor foi avaliada inicialmente, após o manchamento e pós-clareamento. Os dados foram submetidos ao teste de ANOVA e Tukey (a= 0,005). Observou-se maior pigmentação do café solúvel (24,4±3,0), seguido pelo vinho tinto (20,2± 2,0) e Coca-Cola® (3,7±1,2). Após o uso do PC 16% foi observada remoção de pigmentos de todos os espécimes de RC. Não houve diferença estatisticamente significante entre o controle (1,4±0,3), Coca-Cola® (1,2±0,4) e vinho tinto (1,6±1,1), apenas o grupo exposto ao café solúvel (5,9±3,3) diferiu estatisticamente do controle. Concluiu-se que os corantes foram capazes de pigmentar a RC, em especial o café solúvel. O clareamento caseiro com PC 16% foi eficaz na remoção dos pigmentos, porém os espécimes expostos ao café solúvel não retornaram à coloração inicial. Pacientes que consomem bebidas com corantes podem apresentar alterações na coloração das restaurações em RC, em especial pelo consumo do café solúvel (AU).

The aim was to evaluate in vitro the color change of composite resin submitted to pigmentation by instant coffee, red wine, and Coke®, as well as the change after bleaching with carbamide peroxide (CP) 16%. Twenty composite resin specimens were fabricated in color A1 (Opallis, FGM) and randomly divided into four groups (n= 5) according to the coloring solutions: instant coffee, Coke®, red wine and, control (distilled water). The initial color was measured with a spectrophotometer Vita Easyshade and then began the process of staining with the staining solutions for seventy-two hours. After staining, home bleaching with carbamide peroxide 16% was carried out for three hours daily for three weeks. The color assessment was performed before and after staining and after bleaching. Data were submitted to ANOVA and Tukey test (a = 0,005). There was greater pigmentation instant coffee (24.4±3.0), followed by red wine (20.2±2.0), and Coke® (3.7±1.2). After bleaching of pigment removal was observed in all resin specimens. There was no statistically significant difference between the control (1.4±0.3) and the groups Coke® (1.2±0.4) and red wine (1.6±1.1), only instant coffee (5.9±3.3) differed from control. It was concluded that the coloring solutions were able to alter resin pigment, especially instant coffee. The at home bleaching was effective for removal of resin pigments exposed to instant coffee, red wine and, Coke® and only the specimens exposed to instant coffee did not return to the initial color of the composite resin. Patients who consume drinks with dyes may present alterations in the color of CR restorations, especially due to instant coffee consumption (AU).

Evaluation of different restorative techniques for filling flared root canals: fracture resistance and bond strength after mechanical fatigue.

PURPOSE: To evaluate the fracture resistance (FR) and bond strength (BS) after mechanical fatigue (MF) of flared root canals restored with different restorative techniques for fiber post cementation. MATERIALS AND METHODS: The root canals of 84 single-rooted premolars were endodontically treated and prepared in order to simulate an oversized root canal, except for the positive control group (PC), in which a prefabricated fiber post (PFP) with a diameter compatible with the post cavity was cemented. In the oversized root canals, alternative restorative techniques for post cementation were tested, as follows: NC: negative control (PFP with a diameter smaller than that of the root canal); AP: PFP + accessory posts; RR: root reinforcement with composite resin; DAP: direct anatomical post; IAP: indirect anatomical post. After the luting procedures using Excite DSC and Variolink II, indirect composite crowns were cemented on composite resin cores and the specimens were mechanically fatigued (1.2 x 106 cycles, 40 N). From each group, 8 specimens were subjected to the push-out BS test and the others 6 specimens to the FR test. For both tests, the data were subjected to ANOVA and Scheffe's tests (α = 0.05). RESULTS: In terms of FR, all alternative techniques showed intermediate performance, being similar to both control groups. In terms of BS, only the groups DAP and IAP were similar to the well-adapted condition (positive control group). CONCLUSION: The use of DAP and IAP should be the first choice for fiber post cementation in oversized root canals.

Restaurações estéticas indiretas: relato de caso clínico / Indirect esthetic restorations: case report

As restaurações indiretas metal tiee têm sido amplamente utilizadas por serem capazes de mimetizar as estruturas do dente natural. O sucesso dessas restaurações pode ser atribuído às propriedades do material empregado, o domínio da técnica pelo Cirurgião-Dentista, além de uma estreita relação com o ceramista. Dentre as várias opções cerâmicas metal free existentes no mercado odontológico o dissilicato de lítio tem sido uma grande opção devido principalmente as nuances estéticas permitidas com este sistema (lPS Empress 2 Ivoclar/Vivadent). Assim, este trabalho demonstra clinicamente por meio da realização de um caso clínico, o emprego de uma cerâmica pura para devolver a harmonia de um sorriso comprometido pela alteração de posição e coloração dos dentes anteriores, alcançando um resultado altamente satisfatório proporcionando bem estar ao paciente e um aumento de sua autoestima.

The indirect restorations free metal has been widely used because they are able to mimic the structures of natural tooth. The success of these restorations can be attributed to the properties of the material used, mastery of technique by a dentist, and a close relationship with the potter. Among the ceramics on the market, the IPS Empress2 (Ivoclar/Vivadent) has featured works by providing durable, aesthetic and high marginal accuracy. This study demonstrates clinically by conducting a case study, the use of a ceramic lithium disilicate to restore the harmony of a smile compromised by changing color and position of the anterior teeth. Providing welf are to the patient and increase their self esteem.

Laminados cerâmicos minimamente invasivos / Minimally invasive porcelain laminate veneers

As facetas diretas em resinas compostas podem ser indicadas para solucionar diversos problemas estéticos, como diastemas, modificações de forma, posição, cor e textura dos dentes anteriores, porém, este material é suscetível ao desgaste e à alteração na coloração, limitando assim, o resultado estético ao longo do tempo. Para compensar tais limitações, foram então propostas restaurações indiretas, tais como laminados cerâmicos. O aperfeiçoamento nas propriedades físicas e mecânicas desses materiais, associado à evolução dos sistemas adesivos e cimentos resinosos, promoveram uma adequada união da cerâmica à estrutura dentária, que proporcionou um aumento na longevidade e desempenho clínico desta modalidade de restauração

Resin composite veneers can solve many aesthetic problems, such as diastema, alterations in shape, position, color and texture of the anterior teeth, but this material is susceptible to wearing and discoloration, limiting the aesthetic result. To compensate for these limitations, indirect restorations, such as porcelain laminate veneers were proposed. The improvement and development in the physical and mechanical properties of ceramic systems, associated with the adhesive systems and resin cements, have resulted in an adequate bonding to tooth structure and ceramics, and thereby increasing the longevity and clinical performance of this type of restoration

Transformação de incisivos laterais conóides com resina composta: relato de caso / Transformation of conoid lateral incisors with resin composite: case report

A atual valorização da estética vai de encontro às discrepâncias de forma e tamanho dental comumente encontradas na clínica diária. Entre essas variações, os incisivos laterais conoides atingem 1,03% da população e podem refletir negativamente na saúde física e psicológica do indivíduo. Os resultados desse trabalho demonstram a possibilidade de resolução estética e funcional de forma simples e conservadora com o uso de resinas compostas

The current valuation of aesthetic aspects stumbles at discrepancies in tooth size and shape commonly found in everyday practice. Among these variations, conoid lateral incisors affect 1.03% of the population and may interfere negatively on the physical and psychological health of the individual. The results of the present study indicate the possibility of a simple and conservative solution with positive aesthetic and functional improvements using composite resins

Effect of etch-and-rinse and self-etching adhesive systems on hardness uniformity of resin cements after glass fiber post cementation.

OBJECTIVE: To evaluate the effects of etch-and-rinse and self-etching adhesive systems on Vickers hardness (VHN) uniformity of dual-cured resin cements after fiber post cementation. METHODS: FIFTY GLASS FIBER POSTS WERE CEMENTED INTO BOVINE ROOTS USING THE FOLLOWING CEMENTING SYSTEMS: Prime&Bond 2.1 Dual Cure and Enforce with light-activation (PBDC-LCEN); Prime&Bond 2.1 and Enforce with light-activation (PB-CLEN); Prime&Bond 2.1 Dual Cure and Enforce without light exposure (PBDC-SCEN); ED Primer and Panavia 21 (ED-SCPN); and Clearfil SE Bond and Panavia 21 (CF-SCPN). The roots were stored in distilled water for 72 h and transversely sectioned into thirds (coronal, medium, and apical). The VHN values of the resin cement layers were measured close to the post and to the dentin wall on the transversely sectioned flat surfaces. The results were analyzed by three-way repeated measures analysis of variance (ANOVA) and Tukey's post-hoc test (pre-set alpha of 5%). RESULTS: Most resin cements presented higher VHN values near the post than near the dentin wall. The ED-SCPN group showed the highest VHN values regardless of the root third, while the self-cured group PBDC-SCEN exhibited the lowest values. The resin cements from the light-activated groups PBDC-LCEN and PB-LCEN showed lower VHN values at the apical third than at the coronal third. The VHN values were not influenced by the root third in self-cured groups PBDC-SCEN, ED-SCPN, and ED-SCPN. CONCLUSION: Depending on the product, bonding agents might promote changes in hardness uniformity of resin cements after post cementation.

Interfacial integrity of bonded restorations with self-etching adhesives: Water storage and thermo-mechanical cycling.

OBJECTIVE: To evaluate the effect of thermo-mechanical cycling (TMC) on the microleakage (µL) and axial gap width (AG) of Class V bonded restorations in premolars using self-etching adhesive systems. The bond strength of composite restorations to dentin (µTBS) using the same adhesives was also evaluated in third molars after water storage: 24 h and 6 months. The research hypotheses were tested for the results of two self-etching adhesives in comparison when a conventional two-step adhesive was used: (1) the µL and AG would be lower, regardless of TMC; (2) the µTBS of self-etching adhesives would be higher, irrespective of evaluation times. METHODS: Sixty Class V composite restorations were made in 30 premolars and bonded with Adper Single Bond 2 (ASB2), AdheSE (ASE), and Adper Prompt L-Pop (APL-P) (n=20). Dentin µL and AG were immediately measured for half of the sample. The other half was evaluated after TMC. Eighteen third molars were also selected and bonded using the same adhesives to test the µTBS to dentin. Specimens were evaluated after 24 h and 6 months of water storage. RESULTS: No differences in µL and AG were found among the groups (P>.05). The µTBS mean values were: ASB2>ASE>APL-P (P<.05); only Adper Single Bond 2 presented a significantly lower µTBS after water storage (P<.05). CONCLUSIONS: The bonding approach does not influence the microleakage and interfacial gap extension. Despite the decrease in the mean values, the bond strength to dentin of the conventional, two-step adhesive remains high after 6 months of water storage.

Regional bond strengths to root canal dentin of fiber posts luted with three cementation systems.

This study evaluated the influence of the cementation system on the regional push-out bond strength and failure pattern of fiber posts to radicular dentin. The roots of 48 extracted human incisors were prepared and divided into 3 groups (n = 16), according to the cementation system: AdperScotchbond Multi-Purpose + resin cement RelyX ARC (SBMP+ARC); Adper SingleBond 2 + RelyX ARC (SB+ARC) and; RelyX U100 self-adhesive resin cement (U100). The posts were cemented as per manufacturer's instructions for each cementation system. After 1 week, the roots were sectioned transversely into 6 discs. Two discs were obtained from the cervical, middle and apical thirds and the push-out test was carried out. The failure pattern was examined on all debonded specimens. The data were analyzed by two-way repeated measures ANOVA and Tukey's test. When U100 was used, no statistically significant difference (p>0.05) was observed among the different root regions. Statistically higher push-out bond strength values were detected in the cervical third for SBMP+ARC and SB+ARC (p<0.05). The U100 showed significantly more mixed failures than SBMP+ARC in the apical third (p<0.05). In conclusion, the self-adhesive cement RelyX U100 was the only cement not sensitive to the root canal region.

Effect of light-curing units on gap formation and microleakage of class II composite restorations

Aim: This in vitro study evaluated gap width formation and marginal microleakage in Class IIcomposite restorations light-cured with three different light-curing units. Methods: Standardizedcavities in the proximal surfaces of 36 human third molars were made with margins located belowthe cementoenamel junction. Cavities were restored with Filtek P60 (3M ESPE), inserted with aphotocondenser tip and light-cured with three different methods: GI - Optilux401 (halogen); GII –ColtoluxLED (LED) and GIII –UltraLumeLED5 (LED). After finishing the restorations, teeth weresubjected to a thermal cycling regimen of 500 cycles (5oC ± 2oC and 55oC ± 2oC), totalizing 500cycles. Thereafter, the teeth were sectioned in a buccolingual direction and in the center of therestorations. Half of the specimens (18) were used to evaluate marginal microleakage, by measuringof dye penetration in cross-sectioned specimens, and the other half was used to analyzed the gapformation width by SEM observations (1000X). Data were submitted to Kruskal-Wallis (α=0.05).Results: The mean values of gap width (μm) were: GI 3.28±3.34; GII 1.48±1.89 and GIII3.11±3.45, and microleakage was not affected by the light-curing units. Conclusions: Therewere no differences between the light-curing methods in gap formation and marginal microleakage.

Comparação da radiopacidade de cimentos resinosos pelos sistemas de radiografia convencional e digital / Comparison of radiopacity in luting resin cements using conventional and digital radiographic systems

Objective: To evaluate the radiopacity of three different resin composite luting cements using the histogram method (conventional radiography) and pixel counting method (digital radiography). Methods: Fifteen specimens were divided into 3 different resin composite luting cement groups: G-I) Cement-Post (Ângelus®, Londrina, Brazil), G-II) RelyX ARC (3MESPE, St. Paul, Minnesota, USA) and G-III) Variolink II (Ivoclar/Vivadent, Schaan, Liechtenstein). After 24 hours, conventional x-rays of the specimens were taken with a lead gauge, making a visual evaluation by scores, to classify the specimen?s radiopacity according to the scale shade (control); they were then scanned for the purposes of analyzing the histogram using Adobe Photoshop CS2, version 8.0. Using the same specimens, x-rays were taken using a Digital X-RAY Intra-Oral System (Gnatus DSR, Ribeirão Preto, Brazil). In this case, the capture of the digital images was performed using Cygnus Imaging® software and the digital radiopacity was measured by counting pixels, using the Image Tool® software (UTHSCSA). Results: The non-parametric Kruskal-Wallis test and Dunn?s post-test (p<0.05) showed that the means and respective standard deviation percentages of white pixels in the digital x-rays were: G-I) 48.94 ±3.16, G-II) 60.22 ±3.86 and G-III) 69.36 ±5.32. As for the conventional x-rays, the means and standard deviations of the histogram analyses that evaluated gray tones were: G-I) 71.98 ±13.02; G-II) 85.40 ±4.47; G-III) 130.51 ±5.82. Conclusion: In conclusion, regardless of the method used (conventional or digital x-rays), G-III obtained the largest radiopacity value.

Objetivo: Avaliar a radiopacidade de cimentos resinosos pelo método do histograma (radiografia convencional) e da contagem de pixels (radiografia digital). Métodos: Foram utilizados 15 corpos-de-prova divididos em três grupos de cimentos resinosos: Grupo I) Cement-Post (Ângelus®, Londrina, Brasil), Grupo II) RelyX ARC (3MESPE, St. Paul, USA) e Grupo III) Variolink II (Ivoclar/Vivadent, Schaan, Liechtenstein). Após 24 horas, foram realizadas radiografias convencionais dos corpos-de-prova juntamente com uma escala de chumbo, realizando assim uma avaliação visual por escores para classificar a radiopacidade dos corpos-de-prova de acordo com a tonalidade da escala (controle); e em seguida, foram escaneadas para análise do histograma no software Adobe Photoshop CS2 versão 8.0. Com os mesmos corpos-de-prova, realizaram-se tomadas radiográficas empregando-se o Sistema Intra-oral de Raio-X Digital (Gnatus, Ribeirão Preto, Brasil), sendo a captura das imagens digitais realizadas com o software Cygnus Imaging® e a radiopacidade digital mensurada pela contagem de pixels com o software Image Tool® (UTHSCSA). Resultados: O teste não-paramétrico de Kruskal-Wallis e Dunn (p<0,05) mostrou que as médias das porcentagens de pixels brancos das radiografias digitais e os seus respectivos desvios-padrão foram: Grupo I) 48,94 ±3,16; Grupo II) 60,22 ±3,86 e Grupo III) 69,36 ±5,32. Já nas radiografias convencionais, as médias e os desvios-padrão das análises do histograma avaliando tons de cinza foram: Grupo I) 71,98 ±13,02; Grupo II) 85,40 ±4,47 e Grupo III) 13,51 ±5,82. Conclusão: Pode-se concluir que utilizando tanto o sistema de radiografia convencional quanto o sistema digital, o Grupo III obteve uma maior radiopacidade.

Auxílio na obtenção de contatos proximais em dentes posteriores / Auxiliary tool for obtaining proximal contacts in posterior teeth

Com o atual avanço tecnológico e estético das resinas compostas, sua utilização é praticamente unânime entre os profissionais da odontologia. Isso ocorre principalmente devido à busca dos pacientes por restaurações que mimetizem a naturalidade dental e proporcionem seu restabelecimento, sem deixar de lado a função. Mesmo com todo esse avanço, ainda há dificuldades técnicas entre os clínicos na obtenção de perfeita superfície de contato. Há, na literatura, diversas alternativas restauradoras que visam a auxiliar nesses procedimentos. Com o objetivo de demonstrar a utilização de um instrumento auxiliar para obtenção de melhores contatos proximais em dentes posteriores, este trabalho apresenta uma sequência clínica de restauração de classe II em resina composta...

The latest technologic and esthetic advances of composite resins made their use universal in dental profession. This also occurred due to patients’ seek for esthetic restorations that mimic tooth anatomy and allow for the rehabilitation of esthetics and function. In spite of all of these advancements, there are some difficulties experienced by the clinicians to obtain tight proximal contacts. The literature reports several techniques to help these procedures. This article present a case report of the use of an auxiliary device to obtain tight proximal contacts in posterior teeth, presenting a clinical sequence of a Class II composite resin restoration...

Associando o clareamento de consultório com o caseiro para aumentar a longevidade- relato de caso / Associating in-office and at-home dental bleaching to improve longevity: case report

Clareamento dental com peróxido de hidrogênio e peróxido de carbamida tem sido amplamente utilizado pelos cirurgiões-dentistas para o clareamento dental. Independentemente da técnica de clareamento utilizada, há regressão da cor após o tratamento, porém, observa-se que o clareamento associado mantém os resultados ao longo do tempo, além de potencializar o efeito clareador. Desta forma, o objetivo deste trabalho foi demonstrar a execução de um caso clínico, em um paciente portador de escurecimento dental generalizado. Foi utilizado a técnica do clareamento dental associado, com peróxido de hidrogênio 35% Mix One Supreme (Villevie, Joinville, Santa Catarina, Brasil) e peróxido de hidrogênio 6% (Mix Day, Villevie, Joinville, Santa Catarina, Brasil) avaliando a efetividade do clareamento imediatamente após o tratamento e a estabilidade da cor após 1 mês e 6 meses da finalização do caso. Significância clínica: a associação entre o clareamento caseiro e o clareamento de consultório pode potencializar o efeito clareador além de melhorar a estabilidade da cor ao longo do tempo

Dental bleaching with hydrogen peroxide and carbamide peroxide has been widely used by dentists for dental bleaching.Regardless of the bleaching technique used is a regression of color after treatment, but it was observed that bleaching associated with maintaining the results over time, and enhance the bleaching effect. Thus, the objective was to demonstrate the implementation of a clinical case in a patient with generalized dental browning. We used the technique of bleaching associated with hydrogen peroxide 35% Mix One Supreme (Villevie, Joinville, Santa Catarina, Brazil) and hydrogen peroxide 6% (Mix Day, Villevie, Joinville, Santa Catarina, Brazil), evaluating the effectiveness immediately after the bleaching treatment and color stability after 1 month and 6 months of completion of the case. Clinical significance: the association between tooth bleaching and whitening office whitening can enhance the effect and improves the stability of color over time

Regional bond strengths to root canal dentin of fiber posts luted with three cementation systems

This study evaluated the influence of the cementation system on the regional push-out bond strength and failure pattern of fiber posts to radicular dentin. The roots of 48 extracted human incisors were prepared and divided into 3 groups (n=16), according to the cementation system: AdperScotchbond Multi-Purpose + resin cement RelyX ARC (SBMP+ARC); Adper SingleBond 2 + RelyX ARC (SB+ARC) and; RelyX U100 self-adhesive resin cement (U100). The posts were cemented as per manufacturer’s instructions for each cementation system. After 1 week, the roots were sectioned transversely into 6 discs. Two discs were obtained from the cervical, middle and apical thirds and the push-out test was carried out. The failure pattern was examined on all debonded specimens. The data were analyzed by two-way repeated measures ANOVA and Tukey’s test. When U100 was used, no statistically significant difference (p>0.05) was observed among the different root regions. Statistically higher push-out bond strength values were detected in the cervical third for SBMP+ARC and SB+ARC (p<0.05). The U100 showed significantly more mixed failures than SBMP+ARC in the apical third (p<0.05). In conclusion, the self-adhesive cement RelyX U100 was the only cement not sensitive to the root canal region.

Esse estudo avaliou a influência do sistema de cimentação na resistência de união regional e os padrões de fratura de pinos de fibra à dentina radicular. As raízes de 48 incisivos humanos extraídos foram preparadas e divididas em 3 grupos (n=16) de acordo com o sistema de cimentação: AdperScotchbond Multi-Purpose + cimento resinoso RelyX ARC (SBMP+ARC); AdperSingle Bond 2 + RelyX ARC (SB+ARC) e cimento resinoso autoadesivo RelyX U100 (U100). Os pinos foram cimentados conforme as recomendações dos fabricantes para cada sistema de cimentação. Após uma semana, as raízes foram seccionadas transversalmente em 6 discos. Dois discos foram obtidos para os terços coronário, médio e apical e o teste de push-out foi realizado. O padrão de fratura foi avaliado em todos os espécimes. Os dados obtidos foram analisados através dos testes ANOVA dois fatores e Tukey. Quando o cimento U100 foi testado, não foram observadas diferenças significativas (p>0,05) entre as diferentes regiões radiculares. Valores de resistência de união significativamente superiores foram encontrados no terço coronário para SBMP+ARC e SB+ARC (p<0,05). O U100 apresentou significativamente mais fraturas mistas que o SBMP+ARC no terço apical (p<0,05). Conclui-se que o cimento resinoso autoadesivo RelyX U100 foi o único cimento não afetado pela região do canal radicular.

Hardness of a bleaching-shade resin composite polymerized with different light-curing sources

The microhardness of a bleaching-shade resin composite polymerized with different light-curing units was evaluated. Composite samples (3M ESPE Filtek Supreme) were applied to brass rings (2 mm in thickness, 5 mm in diameter). Three commercial LED lights were used to polymerize the specimens and the results were compared to those of a conventional halogen light. The light sources used in the present study were: Demetron Optilux 401 (QTH), 3M ESPE Elipar FreeLight (LED 1); Kerr L.E.Demetron I (LED 2), and ColtoluxLED lights (LED 3). The microhardness of the top and bottom surfaces was assessed with a digital Vickers hardness-measuring instrument, under load. At the bottom surface, no significant difference among the light sources was observed (two-way ANOVA). At the top surface, the QTH light source presented significantly higher hardness values compared to the values observed when LED 1 and LED 3 were used. There were no significant differences between the QTH and LED 2 light sources. Significantly higher hardness values were also found at the top surface when compared to the values observed at the bottom surface. The power density of the polymerization light sources seemed to be responsible for the observed resin composite hardness, not their irradiance.

Avaliou-se a microdureza de uma resina composta para dentes clareados fotoativada com diferentes fontes de luz fotoativadora. Espécimes de resina composta (3M ESPE Filtek Supreme) foram aplicados a cilindros de latão (2 mm de espessura, 5 mm de diâmetro). Três fontes comerciais de luz LED foram utilizadas para polimerizar os espécimes e os resultados foram comparados aos obtidos utilizando-se uma fonte de luz halógena convencional. As fontes de luz utilizadas no presente estudo foram: Demetron Optilux 401 (QTH), 3M ESPE Elipar FreeLight (LED 1); Kerr L.E.Demetron I (LED 2), e ColtoluxLED lights (LED 3). A microdureza das superfícies topo e base foram avaliadas com um microdurômetro digital (Dureza Vickers), sob aplicação de carga. Na superfície base não se observou diferença significante entre as fontes de luz utilizadas (ANOVA, dois critérios). Na superfície topo, a fonte de luz QTH apresentou valores de dureza significantemente maiores quando comparado aos valores apresentados quando LED 1 e LED 3 foram utilizadas. Não houve diferença significante entre QTH e LED 2. Observou-se também diferença significante entre os valores das superfície topo, que foram significantemente superiores, e base. A densidade de potência das fontes de luz fotoativadoras mostrou ser responsável pela dureza da resina composta e não a irradiância.

Hardness of a bleaching-shade resin composite polymerized with different light-curing sources.

The microhardness of a bleaching-shade resin composite polymerized with different light-curing units was evaluated. Composite samples (3M ESPE Filtek Supreme) were applied to brass rings (2 mm in thickness, 5 mm in diameter). Three commercial LED lights were used to polymerize the specimens and the results were compared to those of a conventional halogen light. The light sources used in the present study were: Demetron Optilux 401 (QTH), 3M ESPE Elipar FreeLight (LED 1); Kerr L.E. Demetron I (LED 2), and ColtoluxLED lights (LED 3). The microhardness of the top and bottom surfaces was assessed with a digital Vickers hardness-measuring instrument, under load. At the bottom surface, no significant difference among the light sources was observed (two-way ANOVA). At the top surface, the QTH light source presented significantly higher hardness values compared to the values observed when LED 1 and LED 3 were used. There were no significant differences between the QTH and LED 2 light sources. Significantly higher hardness values were also found at the top surface when compared to the values observed at the bottom surface. The power density of the polymerization light sources seemed to be responsible for the observed resin composite hardness, not their irradiance.

Análise in vitro da resistência adesiva de resinas compostas em cavidades de classe II, através do teste de microtração: efeito de diferentes técnicas restauradoras / In vitro analysis of the tensile bond strength of the composite resin in class II cavities, throught the microtensile bond test: effect of different restorative techniques

O objetivo deste trabalho foi analisar in vitro a resistência adesiva, em cavidades de classe II, restauradas com resinas compostas, através do teste de microtração . Foram realizadas cavidades padronizadas, de classe II, tipo slot, nas superfícies mesial e distal de 24 dentes terceiros molares humanos e hígidos. Os dentes foram aleatoriamente divididos em 6 grupos com 16 espécimes cada. O procedimento restaurador foi realizado através de técnica de incrementos múltiplos com as resinas compostas P60 (compactável) e Z250 (multiuso), sob efeito de diferentes técnicas restauradoras, a saber: Grupo PT1- adesivo + P60 ; Grupo PT2- adesivo + P60 + ponta fotocondensadora transparente; Grupo PT3- adesivo + flow + P60; Grupo ZT1- adesivo + Z250; Grupo ZT2- adesivo + Z250 + ponta fotocondensadora transparente; Grupo ZT3- adesivo + flow + Z250. O sistema adesivo utilizado foi o Single Bond (3M ESPE). Após as restaurações, os dentes foram armazenados em água destilada em estufa a 37°C, durante 24 horas. A seguir, os dentes foram termociclados por 500 ciclos (5°-55°) e então, seccionados paralelamente ao longo eixo com disco diamantado, no sentido vestíbulo - lingual e mesio - distal, obtendo-se amostras em forma de palitos, com área de secção transversal de 0,50mm²±0,1mm² . Antes do teste de tração, os palitos tiveram suas áreas de união medidas e anotadas, e então, foram fixados pelas suas extremidades ao dispositivo de microtração com um adesivo instantâneo e a seguir, submetidos ao ensaio de tração em máquina de testes universal (MTS) operada a velocidade de 0,5mm/min. Após a fratura, os valores de resistência adesiva foram calculados e expressos em MPa. O modo da fratura no lado de dentina foi classificada individualmente, com lupa estereoscópica com aumento de 40X. Os dados foram submetidos a análise estatística e demonstrou que: 1- os maiores valores de resistência adesiva foram para o grupo PT2 , o qual associou a resina P60 com a ponta fotocondensadora transparente, sendo diferentes estatisticamente aos grupos PT1 e PT2; 2- os grupos que utilizaram a resina flow, ou seja, PT3 e ZT3, não apresentaram melhoras no aumento da resistência de união; 3- Para os grupos ZT1, ZT2 e ZT3, não foram encontrados diferenças estatísticas significantes entre si e entre os demais grupos estudados e 4- as falhas de união foram predominantemente adesivas.

The aim of this work was to analyse in vitro of the tensile bond strength in class II cavities, recuperated with composite resins, throught the microtensile bond test. Standardized cavities were prepared, slot type , in the surfaces mesial and distal of 24 humans molars teeth third and health. The restorations procedures were carried out using the technique of multiple increments with P60 and Z250 resin. The teeth were randoly divided in to 6 groups of 16 specimens each, to know: Group PT1- adhesive+P60; Group PT2- adhesive+P60+ transparent photocondenser point; Group PT3-ahesive+flow+P60; Group ZT1-adhesive+Z250; Group ZT2- adhesive+Z250+ transparent photocondenser point; Group ZT3- adhesive+flow+Z250. The adhesive system were utilized Single Bond (3M/ESPE). After the restorations, the teeth were storage in destilled water for 24h at 37°C. After were thermocycled for 500 cycles at preset temperatures of 5° and 55°C, and the teeth were sectioned with a diamond disc, perpendicularly to the adhesive interface in buccal-lingual an mesio-distal directions, being obtained samples in sticks form with cross-sectional areas of 0,5 mm². Before testing sticks had their measured and logged union areas. The specimens were then attached to a testing apparatus and tensile load was applied by universal machine at a crosshead speed of 0.5mm/min. After the fracture values of the tensile bond strenght were calculated and expressed in MPa. The dentin surfaces surfaces was examined with aid of glass magnifying stereoscopic with 40X, being verifield the way of failures. The results were submitted statistical analysis showed : 1- the largest values of shear bond strenght went to the group PT2, wich associated the resin P60 with the point photocondenser transparent; 2- the groups that you/they the resin flow didn't present improvements in the increase of the union resistance ; 3- for the groups ZT1, ZT2 e ZT3 they were not found statistical differences to each other and enter the other groups in study ; e 4- The bond failures between matrials, were maily adhesive