Prevention of postoperative tooth sensitivity: a preliminary clinical trial.

The purpose of this study was to evaluate clinically the effects of pre-treatments with a 35% hydroxyethyl metacrylate/5% glutaraldehyde dentine desensitizer (Gluma Desensitizer) and a 2% chlorexidine-based cavity disinfectant (Cav-Clean) on postoperative sensitivity. Three premolar teeth with no pain symptoms were selected from each one of 17 patients, totalling 51 teeth, for which Class II restoration using a composite was indicated. Each one of the three premolar teeth of the same patient was submitted to a different treatment. After acid etching, only a dental adhesive was applied to the first tooth, which served as the control. Gluma Desensitizer dentinal desensitizer was applied to the second premolar tooth prior to applying the dental adhesive. Cav-Clean cavity disinfectant was used on the third premolar tooth before applying the dental adhesive. Only one tooth was restored per session, and all premolar teeth were restored with a condensable composite, according to current restoration technique guidelines. Sensitivity to different stimuli (cold, heat, sweet and dental floss) was assessed on Day 1, Day 4 and Day 7 by questionnaire following restorative procedures. The results of this clinical research showed that, as far as the investigated stimuli and postoperative course are concerned, there was no statistically significant difference in the three different treatments (P>0.05). Postoperative sensitivity resulting from Class II restorations using composite resin cannot be completely eliminated with the prior use of a dentinal desensitizer or a cavity disinfectant. In day-to-day clinical treatment, postoperative sensitivity may possibly be related to the technique employed.

SEM evaluation of the interaction between a three-step adhesive and dentin.

Interaction between resin tags and microtags of adhesive systems and dentinal collagen fibrils is a poorly understood aspect of adhesion. This study evaluated this interaction in 25 recently extracted human third molars. Each tooth was embedded in an epoxy resin and cross-sectioned to obtain two 1-mm-thick dentin disks. The outer dentin surfaces were polished with wet 600-grit sandpaper to create a uniform smear layer. After etching with 35% phosphoric acid for 15 seconds, the primer and adhesive of Scotchbond Multi-Purpose and the resin composite Z100 (3M Dental Products, St Paul, MN 55144, USA) were placed on the dentinal surfaces according to the manufacturer's instructions. The disks were left in distilled water at 37 degrees C for two weeks, then fractured perpendicular to the bonded surfaces in order to obtain two hemi-disks. The fractured surfaces were treated with 2N-chloridric acid and processed for scanning electron microscopy. Gold-coated specimens were examined with a JEOL 6100 scanning electron microscope. Results showed a hybrid layer with resin tags of approximately 100 microm in length and numerous and fine branching resin microtags. The tags and microtags created by this three-step adhesive system were observed in intimate contact with the collagen fibrils of dentin, even in deeper zones which were not affected by acid etching. It suggests that adhesion to dentin may include both micromechanical and chemical aspects.

Long-term clinical evaluation of fracture and pulp injury following glass-ionomer cement or composite resin applied as a base filling in teeth restored with amalgam.

The aim of this research was to analyse the long-term clinical behaviour of two dental materials applied as filling under silver amalgam restorations: glass-ionomer cement (GIC) and composite resin with adhesive system (CR). In this study, 117 posterior teeth (29 premolars and 88 molars) were selected with carious lesions which resulted in great loss of dentin and cusps with unsupported enamel. After caries removal, cavities were prepared and totally filled with GIC or with CR. In a following visit, new cavities were prepared, leaving the employed filling material as a base and support for the enamel, which were then restored with silver amalgam. Restorations were evaluated periodically after 6 months and up to 5 years. Both fracture and pulpal involvement rates were low. Although differences could be observed in the behaviour of the materials, statistical survival estimation showed that the performances of GIC and CR as filling material were similar. There was a significant association both between kind of tooth (molar or premolar) and long-term survival of the restorations; and between degree of unsupported enamel and the same long-term survival. Our results confirmed that the technique in which GIC or CR are used as filling under silver amalgam restorations is clinically acceptable.

[Pit sealing of deciduous and permanent molars. In vivo evaluation]. / Selante em molares decíduos e permanentes. Avaliação in vivo.

The authors studied a fissure sealant retention in deciduous molars and first permanent molars. The assessment of the sealant retention was performed at six months intervals. After eighteen months study period a greater sealant on the deciduous molars was observed, in a decreasing order as follow: upper and lower first permanent molars. It was also shown that greatest loss of sealant occurred on the disto occlusal pit of the upper first permanent molars.