Postoperative Sensitivity of Composite Replacement of Amalgam Restoration: A Randomized Clinical Trial.

PURPOSE: This randomized clinical trial aimed to evaluate the postoperative sensitivity of different resin composite/adhesive materials, placed either by an incremental or bulk-fill technique in posterior resin composite replacement of amalgam restorations. METHODS AND MATERIALS: A total of 47 patients with good overall health and at least four class I or class II amalgam restorations to be replaced participated in this study. The characteristics of 188 cavities were registered and randomly restored using incremental (Z350XT, 3M) or bulk-fill (Filtek Bulk Fill, 3M; Sonic Fill, Kerr; and Opus Bulk Fill, FGM) technique. The postoperative sensitivity was assessed using a Visual Analog Scale (0-100) after 24 hours, 7 days, and 30 days. Pain scores were temporally analyzed using Friedman test followed by Dunn post hoc test (α=0.05). The frequency of tests was calculated according to the frequency and percentage of the McNemar test. RESULTS: The restorative technique and the bulk-fill system used did not affect the postoperative sensitivity, except for Filtek Bulk Fill group, which presented less postoperative sensitivity after 24 hours (p=0.037). Regardless of the restorative material, the postoperative sensitivity decreased after 24 hours, and no differences were found after 7 and 30 days. CONCLUSIONS: After 1 week, the filling technique and the bulk-fill system have no influence on the postoperative sensitivity.

Evaluation of Novel Plant-derived Monomers-based Pretreatment on Bonding to Sound and Caries-affected Dentin.

This study evaluated the influence of new monomers derived from cashew nut shell liquid (CNSL) applied for dentin biomodification on resin-dentin bond strength, nanoleakage, and micropermeability to sound and artificially-created caries-affected dentin. Human dentin specimens were assigned to five groups, according to the following dentin pretreatment solutions: Absolute ethanol (control), 2 wt% grape seed extract (Vitis vinifera), 2 wt% cardol [from cashew nut shell liquid (CNSL)], 2 wt% cardol-methacrylate or 2 wt% cardanol-methacrylate applied on sound and artificial caries-affected dentin. Specimens were analyzed after 24 hour or 1 year of water storage. Microtensile bond strength (µTBS) (n=6), interface micropermeability (n=3), and silver nanoleakage (n=6) were assessed using a universal testing machine, confocal laser scanning microscope, and scanning electron microscope, respectively. In sound dentin, no difference in bond strength was observed between the groups in either storage period. In artificial caries-affected dentin, pretreatment with cardol-methacrylate resulted in statistically higher bond strength than all the other treatments in both storage periods. Cardol-methacrylate treatment resulted in less nanoleakage, along with improved interfacial integrity, compared to further treatments in artificial caries-affected dentin. Regarding micropermeability analysis, all treatments depicted deficient sealing ability when applied on artificial caries-affected dentin, with the presence of gaps in the control group. In conclusion, cardol-methacrylate is a promising plant-derived monomer to reinforce the hybrid layer, since it preserved resin-dentin bond strength and improved dentin bonding, especially to caries-affected dentin, a well-known harsh substrate for adhesion longevity.

In vitro effect of children's toothpaste on brushing abrasion of eroded primary enamel.

PURPOSE: Emerging data have suggested that acid erosion has become an increasing clinical problem in pediatric dentistry. This study aimed to investigate the abrasive effects of two commercial toothpastes on primary enamel eroded by orange juice using an in vitro model. METHODS: Thirty enamel slabs were obtained from primary teeth and then randomly assigned to three groups (n = 8) comprising two different toothpastes: G1-control-distilled water; G2-Dentifrice A (containing no fluoride); and G3-Dentifrice B (1.100 ppmF-NaF). Each slab had one half protected to provide a control side, and the other one was subjected to treatments. The slabs were submitted to daily erosive challenges (3×/day, 2 min) in concentrated orange juice (pH 3.38) associated with abrasive challenges using a tooth-brushing machine (150 brush movements for each cycle). During the experimental period, the slabs were kept in 37 °C artificial saliva, and the experiment was carried out for 5 days. The depths of the resulting eroded areas were measured by stylus profilometry. The data were analyzed using ANOVA and the Tukey-Kramer test (α = 5%). RESULTS: Tooth loss (µm, mean ± SD) was 2.46 ± 1.18 for G1, 3.32 ± 2.12 for G2 and 2.14 ± 1.03 for G3. Therefore, the NaF dentifrice (Dentifrice B) produced significantly less mineral loss (p = 0.04) than dentifrice A. CONCLUSIONS: The findings suggest that fluoride toothpaste could protect primary enamel against erosion.

Catechin-based Dentin Pretreatment and the Clinical Performance of a Universal Adhesive: A Two-year Randomized Clinical Trial.

CLINICAL RELEVANCE: At 24 months, the dentin pretreatment with epigallocatechin-3-gallate did not impair the clinical performance of the adhesive Single Bond Universal regardless of the bonding strategy used. SUMMARY: Purpose: To evaluate the two-year effect of dentin pretreatment with epigallocatechin-3-gallate (EGCG) on the clinical performance of restorations of noncarious cervical lesions (NCCLs) with Single Bond Universal, applied in two different modes (self-etch and etch-and-rinse).Methods and Materials: In this randomized clinical trial, 33 volunteers were selected, and 156 NCCLs were assigned to four groups: ER, etch-and-rinse; ER-EGCG, 0.1% EGCG dentin pretreatment + etch-and-rinse; SE, self-etch; and SE-EGCG, 0.1% EGCG dentin pretreatment + self-etch. The NCCLs were restored with a nanofilled resin composite and evaluated at baseline and at six, 12, 18, and 24 months using FDI criteria for retention, marginal staining, marginal adaptation, caries, and postoperative sensitivity. Two evaluators were blinded to the treatments performed, and impressions were taken for resin replicas to allow indirect observations. Statistical analyses were performed with Kruskal-Wallis and McNemar tests with a significance level of 5%.Results: Six restorations (one from ER, two from SE, one from ER-EGCG, and two from SEEGCG) were lost at 24 months with no significant differences (p>0.05). The retention rates were 97.0% (ER and ER-EGCG), 94.1% (SE), and 94.2% (SE-EGCG). For marginal adaptation, a significant difference was detected between the baseline and 24 months for the SE group (p=0.0313). There were no statistical differences among all other evaluated criteria at 24 months, neither for each group at baseline nor for 24-month comparisons (p>0.05).Conclusions: The pretreatment with EGCG provided no benefit in the clinical performance of the adhesive regardless of the bonding strategy used. In addition, it adds an additional required step to the restorative procedure.

Effect of Polymeric Microparticles Loaded With Catechin on the Physicochemical Properties of an Adhesive System.

The objective of this study was to synthesize and characterize epigallocatechin-3-gallate (EGCG)-loaded/poly(D-L lactide-co-glycolide) acid (PLGA) microparticles, evaluate their effects on degree of conversion and release assay of adhesives, and subsequently to examine the resin-dentin bond strength of two EGCG formulations (free EGCG or loaded into PLGA microparticles) applied as a pretreatment or incorporated into an adhesive system. The formulations were prepared according to a PLGA:EGCG ratio of 16:1 using the spray-drying technique. The size and polydispersity index were determined by light scattering in aqueous dispersion. The degree of conversion (%DC) and release assay were assessed by Fourier transform infrared spectroscopy and ultraviolet-visible spectrophotometer, respectively. Subsequently, 45 third molars were divided into five groups (n=9) according to the different EGCG application modes and prepared for bond strength testing in a universal testing machine. Results demonstrated no statistically significant difference among the DC means after the PLGA microparticles were loaded with EGCG. For the release assay, the 1.0% PLGA/EGCG group presented better results after being elected for use in the bond strength test. The resin-dentin bond strengths of the experimental groups after 12 months of water storage were significantly higher than in the control group. EGCG could improve the durability of the resin-dentin bond over time and promote a new era for adhesive dentistry with the concept of controlled release.

Biological restorations as an alternative to reconstructing posterior teeth: a case report.

This article reports on a three-year follow-up of two biological restorations performed on a 15-year-old female patient. After clinical evaluation, tooth fragments from extracted permanent molars were obtained from a Human Teeth Bank and were autoclaved, adjusted to the prepared cavity, and bonded to the remaining tooth structure with dual resin cement. The technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed permanent molars are discussed.

Electrogeneration of aluminium to remove silica in water.

This paper presents the results of a study on electrogeneration of aluminium, as a coagulant to remove silica in make-up water for cooling towers. Three electrochemical systems were tested, two with aluminium electrodes (one with polarity change and another without it), and a third one with aluminium anodes and cathodes of stainless steel. From the obtained results it was concluded that under the studied conditions, the most advantageous system to produce aluminium and remove silica is the one with both electrodes of aluminium working with direct current. Due to chemical production of aluminium at the cathode, the concentration of aluminium in the water at the outlet of the electrochemical reactor is much higher than the one calculated according to Faraday's law. Under the tested conditions it was possible to remove up to 66% of silica from water containing around 50 mg L(-1).

Urban air pollution and chronic obstructive pulmonary disease-related emergency department visits.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) can have recurrent disease exacerbations triggered by several factors, including air pollution. Visits to the emergency respiratory department can be a direct result of short-term exposure to air pollution. The aim of this study was to investigate the relationship between the daily number of COPD emergency department visits and the daily environmental air concentrations of PM(10), SO(2), NO(2), CO and O(3) in the City of São Paulo, Brazil. METHODS: The sample data were collected between 2001 and 2003 and are categorised by gender and age. Generalised linear Poisson regression models were adopted to control for both short- and long-term seasonal changes as well as for temperature and relative humidity. The non-linear dependencies were controlled using a natural cubic spline function. Third-degree polynomial distributed lag models were adopted to estimate both lag structures and the cumulative effects of air pollutants. RESULTS: PM(10) and SO(2) readings showed both acute and lagged effects on COPD emergency department visits. Interquartile range increases in their concentration (28.3 microg/m(3) and 7.8 microg/m(3), respectively) were associated with a cumulative 6-day increase of 19% and 16% in COPD admissions, respectively. An effect on women was observed at lag 0, and among the elderly the lag period was noted to be longer. Increases in CO concentration showed impacts in the female and elderly groups. NO(2) and O(3) presented mild effects on the elderly and in women, respectively. CONCLUSION: These results indicate that air pollution affects health in a gender- and age-specific manner and should be considered a relevant risk factor that exacerbates COPD in urban environments.

Effects of HEMA/solvent combinations on bond strength to dentin.

Re-expansion of dried demineralized dentin is required to optimize resin adhesion. This study tested the hypothesis that bond strengths to dentin depend upon the ability of experimental HEMA(2-hydroxy-ethyl-methacrylate)/solvent primers to re-expand the matrix. Dentin surfaces were acid-etched with 37% phosphoric acid for 20 sec, air-dried for 30 sec, primed with either 35/65% (v/v) HEMA/water, HEMA/methanol, HEMA/ethanol, or HEMA/propanol for 60 sec, and bonded with 4-META-TBBO(4-methacryloyloxyethyl trimellitate anhydride-tri-n-butyl borane) adhesive. After storage in water for 1 day at 37 degrees C, the samples were prepared for microtensile bond strength testing. We used transmission electron microscopy to measure the width of interfibrillar spaces in the hybrid layers. The HEMA/ethanol primer and the HEMA/propanol primer produced the highest and the lowest bond strengths, respectively (p < 0.05). Bond strengths were directly correlated with the width of the interfibrillar spaces (p < 0.05). Bond strengths are related to the ability of the primer to maintain the re-expansion of collapsed demineralized dentin matrix.

Effects of prism orientation on tensile strength of enamel.

PURPOSE: This study tested the hypothesis that the tensile strength of enamel varies according to prismatic orientation. MATERIALS AND METHODS: Eight extracted, caries-free human third molars were thoroughly cleaned with pumice and water. The entire enamel surface was conditioned with 37% phosphoric acid for 30 s, air dried, and bonded with Single Bond adhesive system. Several layers of composite (Z-100) were incrementally applied to the crown to build up a "cube-like" resin structure approximately 5 mm thick covering the entire crown of the teeth. The teeth were stored for 24 h in water at 37 degrees C, and then the crown was serially, vertically sectioned in a mesio-distal direction to obtain several slices approximately 0.7 mm thick. The slices were sectioned into halves, and each half was gently trimmed from both sides with a diamond bur to reduce the cross-sectional area to a "neck" located in enamel, either on the external slope or functional slope of the cusps. The specimens were trimmed to permit testing of enamel with its prisms either oriented parallel (PL) or perpendicular (PD) to the applied load. The trimmed specimens were glued to the fixtures of a Vitrodyne tester and stressed in tension at 0.5 mm/min. SEM images were taken from the fractured surfaces to examine the site of failure and confirm the prism orientation. RESULTS: Mean tensile strength of enamel was 24.7 +/- 9.6 MPa (n = 22) for PL and 11.4 +/- 6.3 MPa (n = 22) for PD oriented enamel prisms (t value = -5.45, p < 0.05). There was no significant difference between specimens originating from different slopes of the cusps (p > 0.05). CONCLUSION: The results showed that tensile strength of enamel is dependent on the prismatic orientation.