Influence of resin cements on cuspal deflection and fracture load of endodontically-treated teeth restored with composite inlays.

OBJECTIVES: To evaluate the influence of resin cements on cuspal deflection, fracture load and failure mode of endodontically-treated teeth restored with composite resin inlays. MATERIALS AND METHODS: Forty maxillary premolars were randomly divided into four groups: G1 (sound teeth, control), G2 (RelyX ARC), G3 (RelyX Unicem) and G4 (Maxcem Elite). The teeth from groups 2, 3 and 4 received mesial-occlusal-distal preparations and endodontic treatments. Impressions were taken with vinyl polysiloxane and poured using type IV die stone. Inlays with Z250 composite resin were built over each cast and luted with the resin cements. A 200-N load was applied on the occlusal surface and the cuspal deflection was measured using a micrometer. The specimens were then subjected to an axial load until failure occurred. The resulting failure mode was analyzed. RESULTS: The means for cuspal deflection (µm) and fracture load (N) followed by the same letter represent no statistically significant difference based on ANOVA and Tukey's test (p < 0.05). Cuspal deflection: G1 = 4.7 (± 1.7)(a), G2 = 12.0 (± 8.9)(a), G3 = 39.0 (± 27.0)(b) and G4 = 56.8 (± 18.2)(b). Fracture load: G1 = 1982 (± 893)(a), G2 = 690.9 (± 225.5)(b), G3 = 679 (± 193.6)(b) and G4 = 465.5 (± 121.6)(b). G1 presented cusp fractures only at the cement-enamel junction (CEJ). There was a high frequency of cusp fractures below the CEJ in G2, G3 and G4. CONCLUSIONS: Composite resin inlays luted with resin cements do not recover the strength of sound teeth. However, teeth restored with composite resin inlays and luted with RelyX ARC can withstand mechanical fatigue longer before failure occurs than those luted with RelyX Unicem and Maxcem Elite.

Effect of the Nd:YAG and the Er:YAG laser on the adhesive-dentin interface: a scanning electron microscopy study.

OBJECTIVE: This study analyzed the adhesive-dentin interface when Nd:YAG and Er:YAG lasers were applied to dentin. BACKGROUND DATA: Lasers applied to dentin cause morphological changes of this tissue. Because adhesive systems bond to dentin through the hybrid layer, it is important to investigate the adhesive-dentin interface when dentin is irradiated with lasers. METHODS: The occlusal dentin of 12 human molars was exposed and polished with 400 and 600 grit silicon carbide abrasive paper. Teeth were randomly divided into six groups: Group 1, adhesive system Adper Single Bond 2 (SB); Group 2, adhesive system Clearfil SE Bond (CSB); Group 3, Nd:YAG laser (60 mJ, 15 Hz, 0.9 W) and SB; Group 4, Nd:YAG laser (60 mJ, 15 Hz, 0.9 W) and CSB; Group 5, Er:YAG (200 mJ, 4 Hz, 0.8 W) and SB; Group 6, Er:YAG (200 mJ, 4 Hz, 0.8 W) and CSB. Blocks of composite resin were built upon the adhesive system. Tooth-resin sets were cut in a mesio-distal direction, resulting in four samples for each group. Surfaces were polished until 1200 grit silicon carbide abrasive paper, followed by diamond pastes. Samples were demineralized, deproteinized, dried, metalized, and evaluated by scanning electron microscopy. RESULTS: SB formed a thicker hybrid layer, with resin tags longer than CSB. Nd:YAG laser application on the dentin surface, prior to the adhesive procedures, resulted in a thinner hybrid layer with fewer resin tags. Er:YAG laser application on the dentin surface, prior to the adhesive procedures, did not allow the formation of a hybrid layer but formed resin tags. CONCLUSION: Nd:YAG and Er:YAG laser changed the adhesive-dentin interface.