ABSTRACT
In addition to providing functionality to patients, contemporary dentistry strives for esthetic excellence. Patients with anterior impairments, such as shape, size, and position alterations, have compromised smile harmony. A multidisciplinary orthodontic-operative dentistry approach has improved the treatment of these patients, since the use of orthodontic appliances in association with direct composite restorations can solve many esthetic problems. Although this treatment strategy is rather widespread, professional skills are necessary for the correct reproduction of the main features of teeth. Moreover, treatment success is directly related to its longevity. With the aid of a 9-year follow-up case report, a simple direct technique associated with an orthodontic treatment for restoring the esthetic appearance of an impaired smile, with good short- and long-term outcomes, based on minimal but essential esthetic repair interventions is discussed. Such coordinated treatment proved to be effective for the establishment and maintenance of an esthetic and pleasant smile.
Subject(s)
Dental Restoration, Permanent/methods , Diastema/therapy , Esthetics, Dental , Orthodontic Space Closure , Smiling , Tooth Abnormalities/therapy , Adolescent , Composite Resins/therapeutic use , Female , Follow-Up Studies , Humans , Patient Care Team , Tooth Bleaching , Tooth ExtractionABSTRACT
High- and low-speed rotary dental handpieces have been used for a long time in restorative dentistry for cavity preparation. However, problems inherent to conventional burs, such as noise, heat and vibration, have led to the development of new dental burs, such as the chemical vapor deposition diamond-coated bur. Its advantages are many, such as less noise, less pain for the patient, precise cutting, conservative cavity preparation, longer lifetime, less injury to the dental structures, no cutting of soft tissues and easier access of the carious lesion. This case report uses a chemical vapor deposition diamond-coated bur to prepare a cavity by direct proximal access, preserving the marginal ridge. The cavity was then filled with glass ionomer cement. The clinical outcome was satisfactory. Direct access to the cavity was possible because of the chemical vapor deposition diamond-coated bur, resulting in comfort for the patient and dentist.
Os instrumentos rotatórios convencionais têm sido utilizados em alta e/ou baixa velocidade há tempos para a confecção de cavidades na odontologia restauradora. Contudo, problemas inerentes a estes equipamentos, como o ruído, calor e vibração mecânica levaram ao desenvolvimento de novos instrumentos, como a ponta de diamante pela tecnologia Deposição Química por Vapor. Esta apresenta uma série de vantagens como menor ruído, procedimento menos doloroso, desgaste preciso e preparo conservador, maior durabilidade da ponta, menor injúria à estrutura dentária, não corta os tecidos moles e acesso facilitado à lesão cariosa. Este trabalho apresenta um relato de caso clínico demonstrando o uso da ponta de diamante Deposição Química por Vapor para a confecção de um preparo cavitário proximal com acesso direto, com preservação da crista marginal, restauração com cimento de ionômero de vidro. O resultado clínico satisfatório foi conseguido, com acesso direto à cavidade em detrimento à configuração das pontas utilizadas, proporcionando conforto para o paciente e cirurgião dentista.
Subject(s)
Female , Young Adult , Glass Ionomer Cements , Dental Caries , Dental Cavity PreparationABSTRACT
A aplicação de soluções de digluconato de clorexidina (CHX), em diferentes concentrações, tem demonstrado potencial em prevenir a progressão da erosão dentinária in situ e a diminuição, com o passar do tempo, dos valores de resistência de união (RU) de resinas compostas (RC) à dentina normal ou afetada por cárie. Entretanto, seu papel na adesão à dentina já erodida é desconhecido. Este estudo se propôs, portanto, a avaliar o efeito da aplicação de soluções de CHX em diferentes concentrações na RU de uma RC à dentina normal (parâmetro para comparações) e à dentina erodida, ao longo do tempo. Terceiros molares humanos hígidos extraídos (n=48) tiveram seu terço oclusal seccionado e as superfícies dentinárias expostas foram somente submetidas à ação de uma lixa de carbeto de silício de granulação 600/1 min (dentina normal-N, n=24), ou subsequentemente erodidas por um refrigerante a base de cola (imersões de 5 min, 3x/dia, 5 dias; dentina erodida-E, n=24). Foram, então, condicionadas (H3PO4 a 37%; 15 s), lavadas, secas e reidratadas com 1,5 L, respectivamente, de água deionizada (controle-NC, n=8 / EC, n=8), de CHX a 0,004% (N0,004%, n=8 / E0,004%, n=8) ou de CHX a 2% (N2%, n=8 / E2%, n=8). O sistema adesivo AdperTMSingle Bond 2® foi aplicado em todos os espécimes e a porção coronária foi incrementalmente reconstruída com a RC FiltekTMZ350®. Depois de armazenados em água deionizada (24 h, 37oC), os espécimes foram seccionados em palitos (secção transversal 0,81 mm2), que foram testados, sob força de tração (EMIC; célula de carga de 50 kgf; 0,5 mm/minuto), imediatamente ou depois de 6 meses ou 1 ano de envelhecimento. As falhas foram analisadas e classificadas em adesivas, mistas, coesivas em dentina ou em resina. Paralelamente, avaliou-se a qualidade da hibridização para cada grupo experimental, por meio da obtenção de imagens em microscopia confocal de varredura a laser de um espécime por grupo, hibridizado pelo mesmo adesivo, mas marcado pela...
The application of chlorhexidine digluconate (CHX) solutions, in different concentrations, has shown potential in preventing the progression of dentin erosion in situ and the decline, in the course of time, of the bond strength (BS) values of composite resins (CR) to normal or caries-affected dentin. However, its role on adhesion to already eroded dentin is unknown. This study aimed, therefore, to evaluate the effect of the application of CHX solutions in different concentrations on BS of a CR to normal (parameter for comparisons) and to eroded dentin over time. Extracted sound human third molars (n=48) had their occlusal thirds sectioned and exposed flat dentin was only submitted to a 600-grit SiC paper/1min (normal dentin- N, n=24), or subsequently eroded by a regular-cola soft-drink (5-min immersions, 3x/day, 5 days; eroded dentin-E, n=24). They were, then, acid-etched (37% H3PO4; 15 s), washed, vigorously dried, and rehydrated with 1.5 L, respectively, of deionized water (control-NC, n=8 / EC, n=8); of 0.004% CHX (N0.004%, n=8 / E0.004%, n=8); or of 2% CHX (N2%, n=8 / E2%, n=8). AdperTMSingle Bond 2® was applied in all specimens and composite core buildups were incrementally constructed with FiltekTMZ350®. After storage in deionized water (24 h, 37°C), specimens were sectioned in beams (cross-section 0.81 mm2), which were tested, under tensile (EMIC; 50 kgf load cell; 0.5 mm/minute), immediately or after 6 months or 1 year of aging. Failures were analyzed and classified in adhesive, mixed, cohesive in dentin or in resin. In parallel, the quality of the hybridization for each experimental group was evaluated, by means of the obtainment of laser scanning confocal microscopy images from one specimen per group, hybridized with the same adhesive, but marked by the addition of rhodamine B and sectioned only mesiodistally. Microtensile data were analyzed by three-way ANOVA and Tukey tests (<0.05). Mean TBS values...
Subject(s)
Humans , Dentin-Bonding Agents/chemistry , Chlorhexidine/pharmacology , Dentin , Composite Resins/chemistry , Tooth Erosion , Dental Bonding/methods , Materials Testing , Surface Properties , Tensile Strength , Time FactorsABSTRACT
A aplicação de soluções de digluconato de clorexidina (CHX), em diferentes concentrações, tem demonstrado potencial em prevenir a progressão da erosão dentinária in situ e a diminuição, com o passar do tempo, dos valores de resistência de união (RU) de resinas compostas (RC) à dentina normal ou afetada por cárie. Entretanto, seu papel na adesão à dentina já erodida é desconhecido. Este estudo se propôs, portanto, a avaliar o efeito da aplicação de soluções de CHX em diferentes concentrações na RU de uma RC à dentina normal (parâmetro para comparações) e à dentina erodida, ao longo do tempo. Terceiros molares humanos hígidos extraídos (n=48) tiveram seu terço oclusal seccionado e as superfícies dentinárias expostas foram somente submetidas à ação de uma lixa de carbeto de silício de granulação 600/1 min (dentina normal-N, n=24), ou subsequentemente erodidas por um refrigerante a base de cola (imersões de 5 min, 3x/dia, 5 dias; dentina erodida-E, n=24). Foram, então, condicionadas (H3PO4 a 37%; 15 s), lavadas, secas e reidratadas com 1,5 L, respectivamente, de água deionizada (controle-NC, n=8 / EC, n=8), de CHX a 0,004% (N0,004%, n=8 / E0,004%, n=8) ou de CHX a 2% (N2%, n=8 / E2%, n=8). O sistema adesivo AdperTMSingle Bond 2® foi aplicado em todos os espécimes e a porção coronária foi incrementalmente reconstruída com a RC FiltekTMZ350®. Depois de armazenados em água deionizada (24 h, 37oC), os espécimes foram seccionados em palitos (secção transversal 0,81 mm2), que foram testados, sob força de tração (EMIC; célula de carga de 50 kgf; 0,5 mm/minuto), imediatamente ou depois de 6 meses ou 1 ano de envelhecimento. As falhas foram analisadas e classificadas em adesivas, mistas, coesivas em dentina ou em resina. Paralelamente, avaliou-se a qualidade da hibridização para cada grupo experimental, por meio da obtenção de imagens em microscopia confocal de varredura a laser de um espécime por grupo, hibridizado pelo mesmo adesivo, mas marcado pela...
The application of chlorhexidine digluconate (CHX) solutions, in different concentrations, has shown potential in preventing the progression of dentin erosion in situ and the decline, in the course of time, of the bond strength (BS) values of composite resins (CR) to normal or caries-affected dentin. However, its role on adhesion to already eroded dentin is unknown. This study aimed, therefore, to evaluate the effect of the application of CHX solutions in different concentrations on BS of a CR to normal (parameter for comparisons) and to eroded dentin over time. Extracted sound human third molars (n=48) had their occlusal thirds sectioned and exposed flat dentin was only submitted to a 600-grit SiC paper/1min (normal dentin- N, n=24), or subsequently eroded by a regular-cola soft-drink (5-min immersions, 3x/day, 5 days; eroded dentin-E, n=24). They were, then, acid-etched (37% H3PO4; 15 s), washed, vigorously dried, and rehydrated with 1.5 L, respectively, of deionized water (control-NC, n=8 / EC, n=8); of 0.004% CHX (N0.004%, n=8 / E0.004%, n=8); or of 2% CHX (N2%, n=8 / E2%, n=8). AdperTMSingle Bond 2® was applied in all specimens and composite core buildups were incrementally constructed with FiltekTMZ350®. After storage in deionized water (24 h, 37°C), specimens were sectioned in beams (cross-section 0.81 mm2), which were tested, under tensile (EMIC; 50 kgf load cell; 0.5 mm/minute), immediately or after 6 months or 1 year of aging. Failures were analyzed and classified in adhesive, mixed, cohesive in dentin or in resin. In parallel, the quality of the hybridization for each experimental group was evaluated, by means of the obtainment of laser scanning confocal microscopy images from one specimen per group, hybridized with the same adhesive, but marked by the addition of rhodamine B and sectioned only mesiodistally. Microtensile data were analyzed by three-way ANOVA and Tukey tests (<0.05). Mean TBS values...
Subject(s)
Humans , Dentin-Bonding Agents/chemistry , Chlorhexidine/pharmacology , Dentin , Composite Resins/chemistry , Tooth Erosion , Dental Bonding/methods , Materials Testing , Surface Properties , Tensile Strength , Time FactorsABSTRACT
OBJECTIVES: The aim of this study was to investigate the superficial texture of composite restorations after different bleaching protocols. METHODS: Filtek Supreme (S), Filtek Z350 (F), and Grandio (G) were compared to Opallis (O) and Filtek Z250 (Z) (control microhybrid composites) and to bovine enamel using three different bleaching agents: 35% hydrogen peroxide Whiteness HP (WHP), 35% Whiteness HP MAXX (WMAXX) and 16% carbamide peroxide Whiteness Standard (WS). Six specimens from each composite were treated using each bleaching agent, according to the manufacturers' instructions. Three random sites were measured for superficial roughness (Hommel Tester T 1000) weekly for each sample. Data were analyzed for each bleaching system using two-way ANOVA and Bonferroni tests at 5% significance level. RESULTS: WHP treatment significantly altered the Filtek Supreme composite over time. When WMAXX was used, Grandio displayed the most significant alterations in surface roughness throughout the evaluation period, which was not observed for the other nanocomposites. Using WS, Filtek Z250 presented significant surface alterations over time, which was not seen in the nanofilled materials. CONCLUSIONS: Surface roughness alteration was material and time-dependent. The bleaching gels affected nanofilled and microhybrid composite resins. Enamel was the surface less affected by bleaching.
ABSTRACT
Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs) have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called 'sandwich' or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions.
Subject(s)
Dental Restoration, Permanent/methods , Glass Ionomer Cements , Tooth Cervix/pathology , Tooth Wear/therapy , Dental Bonding , Dental Cavity Preparation/methods , Glass Ionomer Cements/chemistry , Humans , Surface Properties , Tooth Abrasion/therapy , Tooth Erosion/therapyABSTRACT
OBJECTIVES: Calcium hydroxide cements have been largely used in deep cavities due to their abilities to stimulate dentin formation. However, their resistance can be relatively low and their solubility relatively high, in many instances. This study evaluated water sorption and solubility of different calcium hydroxide cements, in order to show alterations that may reduce their effectiveness. MATERIAL AND METHODS: Five discs (20 mm in diameter and 1.5 mm thick) of three different materials (Biocal, Dycal and Hidro C) were prepared with the aid of a ring-shaped metallic matrix. After being stored at 37 degrees C for 24 h, the discs were weighed on a precision weight scale, dehydrated and weighed again. Immediately after weighing, discs were stored for a week in 50 mL of distilled water at 37 degrees C and, then, weighed again, dehydrated and submitted to a new weighing. The loss of soluble material and its water sorption was obtained from the difference between the initial and the final dry mass of each disc, after 1 week of immersion in water. Data were analyzed for significant differences by two-way ANOVA and Tukey's test (p<0.05). RESULTS: Mean water sorption values (g) +/- standard deviation and percentage (%), for each evaluated cement, were: Biocal (0.006 +/- 0.001 / 2.15); Dycal (0.016 +/- 0.004 / 5.49); and Hidro C (0.025 +/- 0.003 / 8.27). Mean solubility values (g) +/- standard deviation and percentage (%), for each evaluated cement, were: Biocal (0.002 +/- 0.001 / 0.72); Dycal (0.013 +/- 0.004 / 4.21); and Hidro C (0.023 +/- 0.004 / 7.65). CONCLUSIONS: Biocal absorbed less water and was less soluble than the other evaluated cements; Hidro C exhibited the highest water sorption and solubility values; and there were significant differences among all evaluated experimental groups.
Subject(s)
Calcium Hydroxide/chemistry , Dental Cements/chemistry , Water/chemistry , Absorption , Adsorption , Desiccation , Humans , Immersion , Materials Testing , Minerals/chemistry , Solubility , Surface Properties , Temperature , Time FactorsABSTRACT
BACKGROUND: Researchers have proposed the restoration of abfraction lesions, but limited information is available about the effects of occlusal loading on the margins of such restorations. Because abfraction is a well-recognized problem, the authors conducted a study to assess the effects of occlusal loading on the margins of cervical restorations. METHODS: The authors prepared 40 wedge-shaped cavities in extracted premolars and restored them with a resin-based composite. They subjected specimens to occlusal loading (150 newtons, 10(6) cycles) on the buccal cusp, on the central fossa or on the lingual cusp, and they stored the control group specimens in deionized water. The authors used fluorescein to delimit marginal defects and evaluated the defects by using laser scanning confocal microscopy. RESULTS: Results of chi2 and Kruskal-Wallis tests (P < .05) showed that specimens subjected to occlusal loading had a higher percentage of marginal gaps (53.3 percent) than did the control specimens (10.0 percent). There were no differences between groups in marginal defect formation or in defect location, length or width. CONCLUSIONS: Occlusal loading led to a significant increase in gap formation at the margins of cervical resin-based composite restorations. CLINICAL IMPLICATIONS: The clinician cannot underestimate the effects of occlusal loading when restoring teeth with cervical wedge-shaped lesions. If occlusal loading is the main factor contributing to lesion formation, the clinician should identify and treat it before placing the restoration or otherwise run the risk that the restorative treatment will fail because of marginal gap formation.
Subject(s)
Dental Marginal Adaptation , Dental Restoration, Permanent , Dental Stress Analysis , Tooth Wear/therapy , Bicuspid , Bite Force , Composite Resins , Dental Restoration, Permanent/methods , Humans , Microscopy, Confocal , Tooth Cervix/pathologyABSTRACT
Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs) have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called "sandwich" or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions.
Subject(s)
Humans , Dental Restoration, Permanent/methods , Glass Ionomer Cements , Tooth Cervix/pathology , Tooth Wear/therapy , Dental Bonding , Dental Cavity Preparation/methods , Glass Ionomer Cements/chemistry , Surface Properties , Tooth Abrasion/therapy , Tooth Erosion/therapyABSTRACT
OBJECTIVES: Calcium hydroxide cements have been largely used in deep cavities due to their abilities to stimulate dentin formation. However, their resistance can be relatively low and their solubility relatively high, in many instances. This study evaluated water sorption and solubility of different calcium hydroxide cements, in order to show alterations that may reduce their effectiveness. MATERIAL AND METHODS: Five discs (20 mm in diameter and 1.5 mm thick) of three different materials (Biocal®, Dycal® and Hidro C®) were prepared with the aid of a ring-shaped metallic matrix. After being stored at 37ºC for 24 h, the discs were weighed on a precision weight scale, dehydrated and weighed again. Immediately after weighing, discs were stored for a week in 50 mL of distilled water at 37ºC and, then, weighed again, dehydrated and submitted to a new weighing. The loss of soluble material and its water sorption was obtained from the difference between the initial and the final dry mass of each disc, after 1 week of immersion in water. Data were analyzed for significant differences by two-way ANOVA and Tukey's test (p<0.05). RESULTS: Mean water sorption values (g) ± standard deviation and percentage ( percent), for each evaluated cement, were: Biocal® (0.006 ± 0.001 / 2.15); Dycal® (0.016 ± 0.004 / 5.49); and Hidro C® (0.025 ± 0.003 / 8.27). Mean solubility values (g) ± standard deviation and percentage ( percent), for each evaluated cement, were: Biocal® (0.002 ± 0.001 / 0.72); Dycal® (0.013 ± 0.004 / 4.21); and Hidro C® (0.023 ± 0.004 / 7.65). CONCLUSIONS: Biocal® absorbed less water and was less soluble than the other evaluated cements; Hidro C® exhibited the highest water sorption and solubility values; and there were significant differences among all evaluated experimental groups.
Subject(s)
Humans , Calcium Hydroxide/chemistry , Dental Cements/chemistry , Water/chemistry , Absorption , Adsorption , Desiccation , Immersion , Materials Testing , Minerals/chemistry , Solubility , Surface Properties , Temperature , Time FactorsABSTRACT
A realizações de restaurações estéticas de resina composta tem sido amplamente difundida na prática odontológica atual. Com o aperfeiçoamento dos sisitemas adesivos e das resinas compostas, é possível realizar preparos cada vez menos invasivos, com segurança quanto às suas aplicações e indicações. Restaurações de resina composta em dentes posteriores têm apresentado resultados satisfatórios de resistência e longevidade, uma vez que apresentam propriedades mecânicas aprimoradas. Dessa forma, este artigo tem como objetivo demonstrar e discutir os principais fatores relacionados à confecção de uma restauração de resina composta em dentes posteriores por meio da substituição insatisfatória, abordando os aspectos de contração de polimerização das resinas e formas de minimizar seus danos.
Subject(s)
Humans , Female , Adult , Composite Resins , Dental Restoration, Permanent , Dentin-Bonding Agents , Esthetics, Dental , Glass Ionomer Cements , Pit and Fissure SealantsABSTRACT
This in vitro study evaluated the effect of erosive pH cycling on the percentage of surface micro-hardness change (%SMHC) and wear of different restorative materials and bovine enamel restored with these materials. Eighty enamel specimens were randomly divided into eight groups according to the restorative materials and immersion media used: GI/GV-resin-modified glass-ionomer, GII/GVI-conventional glass-ionomer, GIII/GVII-resin composite and GIV/GVIII-amalgam. Over a period of seven days, groups GI to GIV were immersed in a cola drink (ERO) for 5 minutes, 3x/day and kept in artificial saliva between erosive cycles. Groups GV to GVIII were immersed in artificial saliva (SAL) throughout the entire experimental period (control). Data were tested for significant differences using ANOVA and Tukey's tests (p<0.05). For %SMHC, considering the restorative materials, no significant differences were detected among the materials and immersion media. Mean wear was higher for the resin modified glass ionomer cement when compared to conventional cement, but those materials did not significantly differ from the others. For enamel analyses, erosive pH cycling promoted higher wear and %SMHC compared to saliva. There were no significant differences in wear and %SMHC of enamel around the different restorative materials, regardless of the distance from the restorative material (50, 150 or 300 microm). In conclusion, there were only subtle differences among the materials, and these differences were not able to protect the surrounding enamel from erosion.
Subject(s)
Dental Enamel/pathology , Dental Materials/chemistry , Dental Restoration Wear/classification , Dental Restoration, Permanent , Tooth Erosion/physiopathology , Animals , Carbonated Beverages , Cattle , Composite Resins/chemistry , Dental Amalgam/chemistry , Glass Ionomer Cements/chemistry , Hardness , Hydrogen-Ion Concentration , Materials Testing , Random Allocation , Resin Cements/chemistry , Saliva, Artificial/chemistry , Surface Properties , Time FactorsABSTRACT
OBJECTIVES: This in situ study evaluated the effect of an erosive challenge on different restorative materials and on enamel restored with these materials, as well as the ability of these materials to protect the adjacent enamel against erosion. METHODS: Ten volunteers wore palatal devices with eight bovine enamel blocks, randomly selected and distributed into two vertical rows, corresponding to the following groups: GI/GV, resin-modified glass ionomer; GII/GVI, conventional glass ionomer; GIII/GVII, composite resin; GIV/GVIII, amalgam. One row (corresponding to groups I-IV) was immersed in a cola drink and the other row (corresponding to groups V-VIII) was subjected to saliva only. The palatal device was continuously worn for 7 days and only half of the appliance (groups I-IV) was immersed in the soft drink (Coca-Cola), 150 mL) for 5 min, three times a day. The study variables comprised the wear (profilometry, microm) and the percentage of surface microhardness change (%SMHC). Data were tested for significant differences by two-way ANOVA and Tukey's tests (p<0.05). RESULTS: Considering the restorative materials, for %SMHC and wear, there were no differences among the materials and between the saliva and the erosive challenge. For enamel analyses, the erosive challenge promoted a higher wear and %SMHC of the enamel than did the saliva. There were no significant differences in wear and %SMHC of the enamel adjacent to the different restorative materials. CONCLUSION: This research data suggest that there is little %SMHC and wear of the studied restorative materials and none of them had a preventive effect against erosion on adjacent enamel, which showed a pronounced wear.
