Five-year clinical evaluation of universal adhesive applied following different bonding techniques: A randomized multicenter clinical trial.

OBJECTIVES: To evaluate the clinical performance of a universal adhesive system (Futurabond U, Voco) when applied following different adhesive strategies in non-carious cervical lesions (NCCLs) after 5 years. METHODS: Fifty participants were included. Futurabond U (Voco) was applied in NCCLs using four adhesive strategies (n = 50 each): only self-etch (SE); selective enamel etching + self-etch (SET + SE); etch-and-rinse with dry dentin (ERD); and etch-and-rinse with wet dentin (ERW). All cavities were restored with Admira Fusion composite resin (Voco). Restorations were evaluated after 1, 3, and 5 years using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. RESULTS: After 5 years, retention rates were 81 % (65.8-90.5) for SE, 87 % (73.2-94.4) for SET + SE, 84 % (69.6-92.6) for ERD, and 78 % (63.6-88.9) for ERW (p > 0.05). Thirty-five restorations were considered to have minor discrepancies in marginal adaptation at the 5-year recall (14 for SE, 9 for SET + SE, 6 for ERD, and 6 for ERW; p > 0.05). Sixteen restorations were detected as a minor marginal discoloration (6 for SE, 4 for SET + SE, 1 for ERD, and 5 for ERW; p > 0.05) and one restoration showed a recurrence of caries (1 for ERW; p > 0.05) at the 5-year recall. No restorations showed postoperative sensitivity after 5 years. SIGNIFICANCE: NCCLs restorations using a universal adhesive showed satisfactory clinical performance after 5 years, regardless of the adhesive strategy.

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial.

OBJECTIVES: This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. METHODOLOGY: A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. RESULTS: After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). CONCLUSION: Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial

Abstract Objectives This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. Methodology A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. Results After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). Conclusion Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Universal Simplified Adhesive applied under different bonding technique's: 36-month Randomized Multicentre Clinical Trial.

OBJECTIVES: To evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco) when applied using different application strategies in non-carious cervical lesions (NCCLs) after 36 months. MATERIAL AND METHODS: Futurabond U was applied in NCCLs of 50 subjects using four adhesion strategies (n = 50 restorations per group): only self-etch (SEE); selective enamel etching + self-etch (SET); etch-and-rinse with dry dentin (ERDry); and etch-and-rinse with wet dentin (ERWet). All cavities were restored using Admira Fusion composite resin (Voco). Restorations were evaluated after 36 months using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. RESULTS: The after 36-month retention rates were 87% (75-92%) for SEE, 94% (83-98%) for SET, 91% (80-97%) for ERDry, and 94% (83-98%) for ERWet. Forty-three restorations were considered to have minor discrepancies in marginal adaptation at the 36-month recall (18 for SEE, 12 for SET, 7 for ERDry, and 6 for ERWet; p > 0.05). One restoration was detected as a minor marginal discoloration at the 36-month recall (1 for SET; p > 0.05). No restorations showed postoperative sensitivity and caries recurrence at 36 months. CONCLUSION: The clinical performance of the Futurabond U did not depend on the employed bonding strategy, and it was considered reliable after 36 months of clinical evaluation. However, greater marginal discrepancy was observed in the self-etch groups. CLINICAL RELEVANCE: NCCLs restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse modes showed satisfactory clinical performance after 36 months.

Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial.

The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB - self-etch/bulk-fill in syringe; SETC - self-etch/bulk-fill in capsules; SETI - self-etch/incremental; SEEB - selective enamel-etching/bulk-fill in syringe; SEEC - selective enamel-etching/bulk-fill in capsules; and SEEI - selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm3) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald's Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22-6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.

Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial.

OBJECTIVES: This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching. MATERIALS AND METHODS: A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48 h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48 h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey's test, respectively. RESULTS: In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar. CONCLUSIONS: It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity. CLINICAL RELEVANCE: The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity. CLINICAL TRIAL REGISTRATION NUMBER: NCT02956070.

Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial

Abstract The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB - self-etch/bulk-fill in syringe; SETC - self-etch/bulk-fill in capsules; SETI - self-etch/incremental; SEEB - selective enamel-etching/bulk-fill in syringe; SEEC - selective enamel-etching/bulk-fill in capsules; and SEEI - selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm3) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald's Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22-6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.

Effect of a dentifrice containing nanohydroxyapatite on the roughness, color, lightness, and brightness of dental enamel subjected to a demineralization challenge.

The dental profession is still pursuing the most effective way to treat white-spot lesions in order to produce a sound and esthetically pleasing enamel surface. The aim of the present research was to evaluate in vitro the effects of a dentifrice with nanohydroxyapatite (nano-HAp) on the roughness, color, lightness, and brightness (gloss) of bovine enamel subjected to pH cycling. Twelve enamel discs prepared from bovine incisors were divided into 2 experimental groups: dentifrice with sodium fluoride (Colgate Total 12 Clean Mint) and dentifrice with nanoHAp (Megasonex). For 14 days, the specimens were subjected to 30 cycles of simulated brushing twice a day as well as to a pH cycling model (6 hours of demineralization and 18 hours of remineralization daily). The roughness, color, lightness, and brightness of all specimens were evaluated at baseline (immediately after specimen preparation) and after 7 and 14 days of treatment. A Tukey test demonstrated that there were no statistically significant differences in the effects of the dentifrices on any parameter after 7 days (P > 0.05). After 14 days, however, there was a statistically significant increase in mean roughness in the group brushed with fluoride dentifrice (P < 0.05). Thus, the nanoHAp containing dentifrice promoted less superficial roughness after 14 days, but both dentifrices were similar in relation to color variation, lightness, and brightness.

Importância do conhecimento das propriedades de três materiais de moldagem (siliconas e poliéter): revisão / Knowledge the properties of three molding materials (silicone and polyether)

Com o objetivo de comparar as principais características de três materiais elastoméricos (Silicona de condensação, Silicona de adição e Poliéter) foi feita uma revisão de literatura. A conclusão foi que a seleção do melhor material para moldagem deve ser baseada nos conhecimentos de suas propriedades físico-químicas, que o sucesso da impressão também depende da habilidade clínica do operador e que a melhor moldagem será obtida quando o profissional dominar o material, controlando todas as possíveis causas de alteração dimensional.

In order to compare the main features of three elastomeric materials (condensation silicone, addition silicone and polyether) was a review of literature. The conclusion was that the selection of the best material for molding must be based on knowledge of their physico-chemical properties, that the success of the print also depends on the clinical skill of the operator and that the best molding Will be obtained when the Professional máster the material, controlling all possible causes of change dimensional.

Importância da área de conexão no planejamento de uma prótese parcial fixa metal free / Significance if the connection area in the planning for a metal free bridge

Este estudo teve como objetivo avaliar a resistência flexural de barras longilíneas confeccionadas no Sistema Empress II, com o intuito de extrapolar os resultados para o planejamento de próteses parciais fixas sem metal. Variou-se a extensão e a proporção altura/largura das barras de teste. Os espécimes foram levados à máquina de ensaios universal, onde foi aplicada uma força contínua. Os valores obtidos foram analisados e demonstraram diferença estatisticamente significante entre os grupos testados, indicando que ao aumentar-se a extensão da área correspondente ao(s) pôntico(s) de 0,8mm para 1,6mm cria-se maior susceptibilidade à fratura. Ficou também demonstrado que a altura da conexão é mais relevante que a largura, quando a extensão corresponde a 0,8mm (ANOVA 0,5%).

The purpose of this study was to evaluate the flexural resistance of logitudinal bars of IPS Empress II, with the aim to extrapolate the results to dental bridges planning. It was obtained bars with different extensions and lengths, with standardized width. The specimens were carried to a universal testing machine, when was applied a continuous force. The values obtained were analyzed and showed significant statistical difference between the tested groups, indicating that with an increase of the surface extension related to the pontic(s) from 0,8mm to 1,6mm, it creates more susceptibility to fracture. It also demonstrated that the connection height its more relevant than the width, when the extension corresponds to 0,8mm (ANOVA 0,5%).

Reabilitação estética utilizando o sistema procera: relato de caso clínico / Aesthetic rehabilitation with procera system: case report

A evolução das cerâmicas odontológicas permitiu a confecção de restaurações que aliam excelência estética a boas propriedades físicas, podendo ser indicadas em diversas situações clínicas, recuperando a harmonia do sorriso, sem prejuízo da resistência e da durabilidade. Sendo assim, este trabalho consiste no relato de um caso clínico onde a cerâmica odontológica do Sistema Procera All Ceram foi utilizada visando a reabilitação estética em dois incisivos superiores.

The evolution of the dentals ceramics allowed the making of restorations that joint aesthetic excellence to good physical properties, being able to be suitable in several clinical situations, recovering the smile’a harmony, without damage of the resistance and of the durability. Being like this, this work consists of the report of a clinical case where the dental ceramic of the Procera AllCeram System was used seeking a esthetic rehabilitation of the maxillary incisors.

Seleção de cor: sugestão de protocolo para obtenção de uma estética satisfatória / Color selection: protocol of sugestion for aesthetics satisfactory

A combinação perfeita da reposição protética da dentição natural é uma das tarefas m,ais desafiantes encontradas pelo cirurgião dentista, uma vez que vários são os fatores envolvidos em questão. Com o objetivo de padronizar uma técnica adequada de seleção de cor foi feita essa revisão de literatura. Conclui-se que além de fatores técnicos e científicos sobre a compreensão da interação entre luz e cor, ambiente ideal e técnica adequada existe ainda o fator fisiológico do olho humano com toda sua complexidade de formação, identificação e percepção de imagem.

The perfect match between a natural teeth and artificial restoration, is one of the most challenge procedures in restorative dentistry, as it has many factors involved. Aiming to standardize a technique suitable for selection of color was the review of literature. It is concluded that factors in addition to technical and scientific understanding about the interaction of light and color, ideal environment and proper technique is still the physiological factors of the human eye with all its complexity of training, identification and perception of image.

Avaliação da variação do pH salivar através da utilização de gomas de mascar contendo xilitol / Evaluation of saliva pH variation through the use of xilitol chewing gums

O objetivo desse trabalho foi avaliar o xilitol contido em uma goma de mascar mediante a variação do pH salivar, comparando-o com a clorexidina. Foram selecionadas 19 crianças que não possuíam clinicamente atividade de cárie. Utilizou-se: xilitol (grupo teste). clorexidina (controle positivo) e sacarose (controle negativo). Coletou-se a saliva de cada criança e foram medidos os pH iniciais e após o uso de cada substância (pH final). Foi concluído que a ação do xilitol na elevação do pH salivar pode ser considerada um efeito anticariogênico, assim como a clorexidina.

Utilizaçäo de dentina artificial: comparaçäo entre resina composta e amálgama. Efeito de restauraçöes em molares endodonticamente tratados / The use of artificial dentin: a comparison between composite resin and amalgam on endodontically treated molars

Os autores avaliaram o efeito de restauraçöes de amálgama de prata e de resina composta na resistência à compressäo de dentes debilitados por acesso endodôntico e pela perda de paredes proximais. Para isto, utilizaram 24 molares divididos em 3 grupos: dentes íntegros, restaurados com amálgama de prata e restaurados com resina composta e sistema adesivo. Concluiu-se que nenhuma das técnicas restauradoras restabelece a resistência a compressäo do dente íntegro e que, entre os materiais restauradores, o grupo das resinas compostas apresentou melhores resultados

Resistência ao cisalhamento de um adesivo dentinário contendo glutaraldeído, com ou sem condicionamento ácido / Shear bond strength of an adhesive with glutaraldheyde with and without dentin acid conditioning

O objetivo deste estudo foi avaliar se um sistema adesivo contendo glutaraldeído, criado especificamente para unir-se quimicamente à dentina, sem condicionamento ácido, apresenta melhor desempenho se executado o condicionamento, com ácido fosfórico a 35 por cento, no substrato dentinário previamente à aplicaçäo do primer. Os testes de cisalhamento, näo mostram diferenças quando utilizado o agente condicionante, indicando que a tentativa de obtençäo de efeito micromecânico, associado à açäo química, näo resultou em melhoria e também näo interferiu negativamente na açäo do adesivo