Influence of surface sealants on the quality of posterior restorations with bulk-fill composites: A 4-year randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years. METHODS: A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05). RESULTS: After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe). SIGNIFICANCE: Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.

Impact of photoinitiator quality on chemical-mechanical properties of dental adhesives under different light intensities / Impacto da qualidade de fotoiniciadores nas propriedades químico mecânicas de adesivos dentais sob diferentes intensidades de luz

Objective: Evaluate the mechanical properties of experimental adhesive models with different photoinitiators (PI) polymerized by LED units of different power densities. Material and Methods: Three groups of adhesive models based on HEMA/BisGMA (45/55) were prepared in association with different PI combinations: G2 (control) ­ 2 PI: 0.5% CQ, 0.5% EDMAB; G3 - 3 PI: 0.5% CQ; 0.5% DMAEMA, 0.5% DPIHP; G4 - 4 PI: 0.5% CQ; 0.5% EDMAB; 0.5% DMAEMA; 0.5% DPIHP. The three formulations were polymerized at two different LED power densities: 550 mW/cm2 and 1200 mW/cm2. The degree of conversion (DC) of adhesive monomers was monitored in situ through the FTIR for 600 s. Specimens were prepared for each formulation for analysis mong adhesive systems (G2

Objetivo: Avaliar as propriedades mecânicas de modelos adesivos experimentais com diferentes fotoiniciadores (PI) polimerizados por unidades de LED de diferentes densidades de energia. Material e Métodos: Três grupos de modelos adesivos baseados em HEMA/BisGMA (45/55) foram preparados em associação com diferentes combinações de PI: G2 (controle) ­ 2 PI: 0,5% CQ, 0,5% EDMAB; G3 - 3PI: 0,5% CQ; 0,5% DMAEMA, 0,5% DPIHP; G4 - 4 PI: 0,5% CQ; 0,5% EDMAB; 0,5% DMAEMA; 0,5% DPIHP. As três formulações foram polimerizadas em duas densidades de potência de LED: 550 mW/cm2 e 1200 mW/cm2. O grau de conversão (DC) dos monômeros adesivos foi monitorado in situ através do FTIR durante 600 s. Amostras foram preparadas para cada formulação para análise de resistência à flexão (FS), módulo de elasticidade (ME), sorção (SOR) e solubilidade (SOL). Os dados foram submetidos aos testes ANOVA 2-fatores e Tukey (5%). Resultados: DC: houve diferença significativa entre os sistemas adesivos (G2

In vitro analysis of the pH stability of dental bleaching gels during in-office procedures.

BACKGROUND: Previous studies have shown that acidic bleaching gels could lead to worse collateral effects during an in-office bleaching procedure, while neutral or basic products leads towards a better experience. Considering this fact, the main purpose of this study was to evaluate the pH behavior of 6 in-office bleaching gels, compared to the information provided by their manufacturers. MATERIAL AND METHODS: Thirty enamel discs of bovine teeth were prepared, the initial colors of which were measured by a spectrophotometer and then divided into 6 groups. A pH meter was used to measure the pH every 30 seconds until the end of each procedure, when a new color evaluation was then made. The Tukey test was used for statistical analysis of the results. RESULTS: There was no difference in the color variation (ΔE) between the groups (p> 0.05). In two groups, the pH variation (ΔpH) showed neutral stability, with initial and final pH averages of 7.04 and 7.11 (p = 0.08) and 7.21 and 7.19 (p = 0.55), respectively; in another, there was alkaline stability, with an initial and final pH average of 8.54 and 8.37 (p = 0.14). In the other three brands, however, the results showed acidification, with initial and final pH averages of 6.14 and 5.22 (p = 0.001), 6.05 and 5.16 (p = 0.001) and 7.14 and 5.83 (p = 0.001), respectively. CONCLUSIONS: In 3 of the evaluated gels, a discrepancy existed between the manufacturer's information and the data obtained, which could lead, considering previous studies discussed throughout this article, to unexpected collateral effects on the patients, especially dental sensitivity. Thus, clinicians and researchers should be aware about pH stability studies of in-office bleaching gels for better predictability and safety on their clinical usage. Key words:Tooth bleaching, Bleaching agents, Hydrogen-ion concentration, Dentin sensitivity, Hydrogen peroxide.