Reanatomização estética dos dentes anteriores com resina composta: relato de caso / Reanatomización estética de dientes anteriores com resina compuesta: reporte de caso / Aesthetic reanatomization of front teeths with composite resin: case report

Introdução: A alta busca por tratamentos estéticos levou a indústria odontológica a aprimorar suas técnicas e desenvolver materiais com novas características que possibilitam a mimetização da estrutura dental, associando alta qualidade estética à saúde. Para isso, é necessário uma anamnese detalhada e exame físico intra e extrabucal, análise morfológica dos dentes e da face, para que a reabilitação proposta seja adequada. Objetivo: O objetivo deste estudo é descrever um caso clínico de reanatomização dos elementos dentais anteriores superiores, por meio de restaurações diretas em resina composta, restabelecendo a estética e função da paciente. Relato de caso: Paciente do sexo feminino, 19 anos, procurou a Clínica Escola da Faculdade de Odontologia do Recife -FOR relatando insatisfação com seu sorriso e declarou não estar disposta a se submeter a um tratamento ortodôntico. Ao realizar o exame clínico, observou-se que havia desalinhamento dos elementos dentários ântero-superiores. Após a realização do enceramento diagnóstico e validação da mesma através do mockupcom resina bisacrílica, optou-se por realizar a reanatomização estética com resina composta nanohíbrida, de forma conservadora, ou seja, sem desgastar os dentes em questão. Conclusão: As etapas do planejamento foram fundamentais para maior previsibilidade e obtenção do excelente resultado. Os materiais e técnicas selecionados para realização dos procedimentos aliaram características de resistência e estética, visando maior longevidade (AU).

Introduction: The high demand for aesthetic treatments has led the dental industry to improve its techniques and develop materials with new characteristics that allow mimicking the tooth structure, associating high aesthetic quality with health. This requires a detailed anamnesis,intra-and extraoral physical examination, and morphological analysis of the teeth and faceto allow an adequate proposed rehabilitation. Objective:The objective of this study is to describe a clinical case of reshaping of upper anterior teeth, by direct composite resin restorations, reestablishing the patient's aesthetics and function. Case report:Female patient, 19 years old, sought the Clínica Escola da Faculdade de Odontologia do Recife -FOR, reporting dissatisfaction with her smile and declared that she was unwilling to undergo orthodontic treatment. Clinical examinationrevealed misalignment of the upper anteriorteeth. After diagnostic waxing and validation by mockup with bis-acryl resin, it was decided to perform the aesthetic reshaping with nanohybrid composite resin in a conservative manner, i.e., without tooth wearing . Conclusion:The planning stages were fundamental for greater predictability and obtaining excellent results. The materials and techniques selected for the procedurescombined resistance and aesthetic characteristics, aiming at greater longevity (AU).

Introducción:La gran demanda para tratamientos estéticos ha llevado a la industria dental a mejorarsus técnicas y desarrollar materiales con nuevas características que permitan mimetizar la estructura dental, combinando una alta calidad estética con la salud. Para que esto ocurra, es necesario realizer una anamnesis detallada y un examen físicointra y extraoral, así como un análisis morfológico de los dientes y de la cara, para que la rehabilitación propuesta sea da adecuada. Objetivo:El objetivo de este studio es describir un caso clínico de reanatomización de los elementos dentales de resinacompuesta, restabeleciendo la estética y función de la paciente. Informe de caso:Paciente del sexo feminine, 19 años de edad, que acudió a la Clínica Escuela de La Facultad de Odontología de Recife ­FOR menifestando insatisfaccíon con su sonrisa y declarando no estar dispuesta a someterse a tratamiento de ortodoncia. En el examen clínico se observódesalineación de los elementos dentarios anterosuperiores. Tras realizar un encerado diagnóstico y validarlo con un mock-up de resina bisacrílica, se optó porrealizer una reanatomización estética con resina compuesta nanohíbrida de forma conservadora, es decir, sin desgastarlos dientes implicados. Conclusión:Las etapas de planificacíon han sido fundamentales para una mayor previsibilidad y la obtención de excelentes resultados. Los materiales y técnicas seleccionados para la realización de los procedimentos combinaron características de resistencia y estética, buscando una mayor longevidad (AU).

Avaliação do nível de conhecimento de acadêmicos de Odontologia sobre fotopolimerização / Evaluation of the knowledge of dental students on light curing

O sucesso clínico de materiais resinosos é dependente de uma adequada polimerização. Diversos materiais fotoativados são utilizados frequentemente nas clínicas-escola de Odontologia. O objetivo desse estudo foi avaliar o nível de conhecimento dos acadêmicos do 10º período de Odontologia do Centro Universitário Maurício de Nassau, Recife/PE,sobre fotopolimerização, por meio de questionário. Os dados foram tabulados e analisados por meio de estatísticas descritivas, teste Qui-quadrado de Pearson e teste Exato de Fischer, com nível de significância de 5% (p<0,05). Os resultados demonstram que 83,8%dos estudantesnão possuem fotopolimerizador, 72,9% não conhecem a potência do aparelho, 56,2% não sabem qual é a potência mínima ideal e apenas 8,5% sabem o nome do aparelho aferidor da irradiância / potência. Além disso, 48,5% não sabem o comprimento de onda ideal para fotoativação de resina composta e 69,2% desconhecemo tipo de aparelho que utilizam (monowaveou poliwave).Em relação ao tempo de fotopolimerização, 60,8% afirmaram utilizar20 segundos em resinas compostas convencionais e 38,5% utilizam por40 segundos em resinas compostas Bulk-fill. Embora 84,6% afirmem usar aparelhos fotopolimerizadores frequentemente, apenas 26,9% sabem a distância ideal da ponteira à restauração. Além disso, 51,5% relataram que fazem a limpeza e desinfecção com álcool 70GL e 45,4% usam barreira plástica. Nesse contexto, pode-se concluir que o nível do conhecimento dos acadêmicos em relação à fotopolimerização foi insatisfatório, exigindo uma abordagem e avaliaçãomais efetivaspara que os discentes tenham consciência da importância clínica deste procedimento e suas consequências (AU).

The clinical success of resin materials depends on adequate curing. Several light cured materials are frequently used in dental school clinics. This study aimed to assess the knowledge of students from the 10th period of Dentistry at Maurício de Nassau University Center, Recife/PE, about light curing, using a questionnaire. Data were tabulated and analyzed by descriptive statistics, Pearson chi-square test and Fisher exact test, at a significance level of 5% (p<0.05). The results show that 83.8% of studentsdo not have a light curing unit, 72.9% do not know the device power, 56.2% do not know the ideal minimum power and only 8.5% know the name of the device that measures the irradiance/power. Also, 48.5% do not know the ideal wavelength for light curing of composite resin and 69.2% do not know the type of device they use (monowave or polywave). Regarding the light curing time, 60.8% stated they used 20 seconds in conventional composite resins and 38.5% used 40 seconds in bulk-fill composite resins. Although 84.6% stated that they use light curing units frequently, only 26.9% know the ideal distance from the tip to the restoration. Additionally, 51.5% reported performing cleaning and disinfection with 70GL alcohol and 45.4% use a plastic barrier. In this context, it can be concluded that the knowledge of students regarding light curing was unsatisfactory, requiring a more effective approach and evaluation so that the students may be aware of the clinical importance of this procedure and its consequences (AU).

Lifting facial não cirúrgico com fios de polidioxanona: revisão de literatura / Non-surgical facelift with polydiaxanone threads: literature review

O objetivo deste estudo foi realizar uma revisão de literatura acerca do lifting facial não cirúrgico com fios de PDO, abordando os diferentes tipos, suas indicações, a degradação no organismo, pla no de inserção, contraindicações, vantagens e possíveis complicações. As buscas foram realizadas nas bases de dados Pubmed, Bireme, Scielo, Sumários de Revistas Brasileiras e BVS, selecionan do-se artigos relevantes disponibilizados entre 2005 e 2020. Sendo os descritores utilizados em português e inglês para busca: "Harmonização Facial", "Fios de Sustentação", "Lifting Facial". Após aplicação dos critérios de inclusão e exclusão, dos 44 artigos encontrados, foram selecionados 16 para esse estudo. O uso dos fios de sustentação facial consiste em um método minimamente inva sivo, indolor, de caráter ambulatorial, anestesia local e efeito imediato. Diante dos possíveis riscos que acompanham o lifting cirúrgico, as pessoas estão buscando por alternativas menos invasivas, como os fios de sustentação. Apesar de não poderem ser considerados como alternativa a cirurgia reparadora convencional, os pacientes muitas vezes acabam optando pelo lifting com fios por se sentirem mais seguros, mesmo com resultados mais modestos. Observou-se que a utilização dos fios de PDO tem demostrado eficácia no rejuvenescimento facial quando bem indicados, apesar da possibilidade de ocorrência de efeitos adversos, normalmente pequenos e passageiros... (AU)

The aim of this study is to perform a literature review about non-surgical facial lifting with PDS threads, addressing its variety of types, indications, organism degradation, insertion plan, contrain dications, advantages and possible complications.The researches were conducted in the Pubmed, Bi reme, Scielo, Sumários de Revistas Brasileiras and BVS data bases, selecting relevant articles available between 2005 and 2020. After applying the inclusion and exclusion criteria, of the 44 articles found, 16 were selected for this study. Being used the following descriptors in Portuguese and English for research purposes: "Facial Harmonization", "Supporti Threads", "Face Lift". The use of facial support threads consists in a minimally invasive, painless, outpatient method, local anesthesia and imme diate effect. Faced with the possible risks that accompany the surgical facelift, people are looking for less invasive alternatives, such as the support wires. Although they cannot be considered as an alternative to conventional reparative surgery, patients often end up opting for a facelift because they feel safer, even with more modest results. It was observed that the use of PDO threads has been shown to be effective in facial rejuvenation when well indicated, despite the possibility of adverse effects, usually small and transient... (AU)

Thirty-six-month clinical evaluation of posterior high-viscosity bulk-fill resin composite restorations in a high caries incidence population: interim results of a randomized clinical trial.

OBJECTIVES: This study compared the clinical performance of two bulk-fill (BF) and one conventional resin composite in a population with a high caries incidence. MATERIALS AND METHODS: A total of 138 class I and II restorations were performed and randomly divided into three groups (n = 46) with equal allocation: Filtek BF (FBF; 3M ESPE), Tetric EvoCeram BF (TBF; Ivoclar Vivadent), and control Filtek Z250 (Z250; 3M ESPE). The evaluations were performed using the USPHS and FDI criteria at baseline and after 12 and 36 months by a previously calibrated evaluator. The Friedman and Wilcoxon tests for paired data were used for statistical analysis (α = 0.05). RESULTS: The DMFT index at baseline was 9.44, with 87% from the decayed component. After 36 months, 108 restorations (n = 36) were evaluated. Two failures were observed for TBF at marginal adaptation and recurrence of caries, resulting in a survival rate of 94.44% and an annual failure rate (AFR) of 1.26%. No equivalence was observed between the criteria for surface roughness, marginal adaptation, and discoloration. CONCLUSIONS: The 36-month clinical performance of high-viscosity BF resin composites was comparable to conventional incremental-filled resin composites. The FDI criteria better presented the restorations' clinical success. However, in the case of failure, both criteria provided the same result. CLINICAL RELEVANCE: High-viscosity bulk-fill resin composites showed excellent performance after 36 months in a high caries incidence population. It can be considered a simplified alternative restoration method that reduces operating time and minimizes possible operator errors.

Do Helmet Use and Type Influence Facial Trauma Occurrence and Severity in Motorcyclists? A Systematic Review and Meta-analysis.

PURPOSE: This article consists of a systematic review of the literature, which verified whether the use and types of helmets reduce the occurrence and severity of facial fractures in hospitalized motorcyclists after traffic accidents. MATERIALS AND METHODS: Prevalence studies and cohort studies, published in Latin American languages with no restrictions on publication dates, were considered. Two authors independently screened reference lists for eligible articles, assessed them for inclusion criteria, and extracted the data using a specific form. Twenty-six articles were selected, all prevalence studies. RESULTS: The patients who used a helmet had a lower prevalence and severity of facial fractures, compared to patients who did not wear a helmet. There were no differences in the occurrence of lower third fractures between patients who used or did not wear a helmet at the time of the trauma; as well as in meta-analysis of occurrence and severity of facial trauma between helmet types (open or closed). CONCLUSIONS: It can be concluded that the use of helmet leads to a lower number of fractures and severity of trauma when compared to nonuse. Regarding the type of helmet, there was no difference in the occurrence and severity of facial fracture in individuals who used closed or opened helmets.

Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial.

OBJECTIVE: This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up. MATERIALS AND METHODS: A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer's instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen's K = 0.84). STATISTICAL ANALYSIS: Fisher's exact test and Pearson's Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman's test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests. RESULTS: After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group. CONCLUSION: The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

Evaluation of bond strength of self-adhesive resin composite repairs / Avaliação da resistência de união de reparos com resina composta auto-adesiva

ABSTRACT Objective: To evaluate the bond strength of repairs with the self-adhering flowable composite Vertise Flow (Kerr) and a conventional composite resin Filtek Z350 (3M ESPE) subjected to different surface treatments. Methods: Forty specimens were divided into four groups: ZV (Filtek Z350 + Vertise Flow, without prior treatment); ZAV (Z350 + Vertise Flow with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); VV (Vertise Flow + Vertise Flow, without prior treatment). After 15 days of storage, the specimens were subjected to microtensile tests (Kratos IKCL3-USB, SP, Brazil), with speed of 0.5 mm/min and 20kg load. For statistical analysis, ANOVA with Tukey tests were used (p < 5%). Results: The mean values of the bond strength were highest respectively in the groups: ZV (36.07 ± 37.63); ZAZ (24.04 ± 28.51); VV (19.39 ± 28.24) and ZAV (16.06 ± 15.66). The bond strength of the repairs between the groups presented satisfactory results. Conclusion: The self-adhesive composite resin Vertise Flow seems to be a viable and fast alternative for composite resins repairs.

RESUMO Objetivos: Avaliar a resistência de união dos reparos com resina composta auto-adesiva Vertise Flow (Kerr) e uma resina composta convencional Filtek Z350 (3M ESPE) submetida à diferentes tratamentos de superfície. Métodos: Quarenta amostras foram divididas em quatro grupos: ZV (Filtek Z350 + Vertise Flow, sem tratamento prévio); ZAV (Z350 + Vertise Flow com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); VV (Vertise Flow + Vertise Flow, sem tratamento prévio). Após 15 dias de armazenamento, as amostras foram submetidas ao teste de microtração (Kratos IKCL3-USB, SP, Brasil), com velocidade de 0,5 mm / min e carga de 20kg.Para análise estatística, foram utilizados os testes ANOVA com Tukey (p <5%). Resultados: Os valores médios da resistência de união foram maiores, respectivamente, nos grupos: ZV (36,07 ± 37,63); ZAZ (24,04 ± 28,51); VV (19,39 ± 28,24) e ZAV (16,06 ± 15,66). A resistência de união dos reparos entre os grupos apresentou resultados satisfatórios. Conclusão: A resina composta auto-adesiva Vertise Flow parece ser uma alternativa viável e rápida para reparos em restaurações com resinas compostas.

Evaluation of microhardness, sorption, solubility, and color stability of bulk fill resins: A comparative study.

BACKGROUND: Due to the increasing popularity of bulk fill resins, there is a concern that their components can be leached; this is because these are inserted in a single 4-5 mm increment. This in vitro study evaluated the microhardness, sorption, solubility, and color stability of three restorative bulk fill resins, namely: Filtek Bulk Fill (FBF), Tetric N-Ceram Bulk Fill (TNC), and Opus Bulk Fill (OBF). MATERIAL AND METHODS: Cylindrical samples were fabricated to be 15 mm in diameter and 1 mm thick (n = 10). For the microhardness test, three random indentations were formulated on the samples using a micro-durometer with a load of 300 gf for 15 s. Sorption and solubility were then evaluated (ISO 4049: 2009). Color stability was analyzed with a digital spectrophotometer three times (initially, after 24 h, and after 7 d) during immersion in coffee and distilled water (control). The Shapiro-Wilk test was applied to analyze normality. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups and the immersion solution, with a significance level of 5%. RESULTS: There were a significant difference in microhardness (p<0.001), with the FBF group showing a higher value compared to the other groups (56.38). The highest average of sorption scores was observed in the OBF group (16.9 µg / mm3), followed by FBF (16.8 µg / mm3) and TNC (11.3 µg / mm3). Solubility was lowest in the OBF group (-2.83 µg / mm3), with a significant difference (p = 0.031). There was also a significant difference after 24 h in the mean ∆E score of all groups (p<0.005). After one week of immersion, the group that pigmented most was OBF (p = 0.008). CONCLUSIONS: The three bulk fill resins had acceptable hardness, sorption, and solubility values. However, all groups showed a high pigmentation rate after 7 d of immersion in coffee. Key words:Bulk fill, color stability, composite resins, microhardness, solubility, sorption.

Influence of the Restorative Strategy on Push-out Bond Strength of the Self-adhesive Composite.

AIM: This study evaluated the influence of the resin composite and bonding strategy on the push-out bond strength of the self-adhesive, Fusio liquid dentin (FUS) (Pentron Clinical), and of two conventional resin composites of different viscosities, Filtek Z250 (3M ESPE) and tetric flow (Ivoclar Vivadent). MATERIALS AND METHODS: Thirty-two bovine incisors were used after disinfection. The roots were sectioned and the buccal and lingual surfaces were polished until a 2-mm slab was achieved, maintaining enamel at the buccal surface and dentin at the lingual surface. Standardized cavities were then prepared (2.0 × 1.5 mm) and restored according to the following bonding strategies: Fusio liquid dentin with selective etching (FUSSE) in enamel, FUS, Filtek Z250, and tetric flow-total etching (TET). All groups were restored in bulk. After 24 hours of storage in distilled water, finishing and polishing were performed. The push-out test was conducted on a universal testing machine (0.05 mm/minute). Data were analyzed through Kruskal-Wallis and Mann-Whitney tests (p = 0.05). The extruded restorations were evaluated under a stereomicroscope (10×) for failure-mode evaluation. RESULTS: There were no statistically significant differences between the groups TET, Z250, and FUS, with 145.59, 108.91, and 104.12 MPa means, respectively. The FUSSE group (40.92 MPa) showed a statistically significant lower bond strength. The predominant failure mode was a mixed failure for all groups. CONCLUSION: The self-adhesive resin composite achieved a satisfactory result on bond strength when compared to conventional composites with regular and low viscosities, except when selective enamel etching was done. CLINICAL SIGNIFICANCE: This study shows that the clinicians must be aware of the viscosity of the phosphoric acid to avoid dentin contamination whenever performing selective enamel etching. And the self-adhesive resin composite studied presented as another restorative alternative.

Prefabricated composite resin veneers: a clinical case report / Facetas pré-fabricadas em resina composta: relato de caso

The authors present a complete clinical case report of functional and aesthetic rehabilitation of the smile harmony of a 23-year-old male patient through periodontal plastic surgery, tooth bleaching and prefabricated composite resin veneers, emphasizing the advantages, limitations and patient's perceptions about the treatment. After clinical and radiographic evaluations, extra and intra-oral photographs were taken, plaster study models were obtained, digital smile design and diagnostic wax-up were performed. The patient accepted and authorized the proposed dental procedures. The treatment proved to be effective, being a practical and safe approach, with aesthetic recovery of the smile harmony and patient satisfaction. (AU)

Os autores apresentam um caso clínico completo envolvendo reabilitação funcional e estética da harmonia do sorriso de um paciente de 23 anos de idade através da associação de plastia gengival, clareamento dental e facetas pré-fabricadas de resina composta, ressaltando vantagens, limitações e a percepção do paciente. Após análise clínica, radiográfica, realizouse fotos intra/extra orais, obteve-se modelos de estudo em gesso e foram realizados o planejamento digital do sorriso e enceramento diagnóstico. Os procedimentos propostos foram aceitos e autorizados pelo paciente antes da sua realização. O tratamento realizado mostrou-se efetivo como uma alternativa prática e segura, com restabelecimento estético e satisfação do paciente.(AU)

Marginal microleakage in Bulk Fill resins / Microinfiltração marginal em resinas Bulk Fill

Introduction: Despite advances and innovations in restorative dentistry, microleakage remains one of the main problems in this area. Objective: To evaluate in vitro marginal microleakage of Bulk Fill resins in class II cavities, with cervical termination in the dentin. Material and method: Cavities, standardized on the mesial and distal surfaces, were prepared in forty top molars and randomly assigned to four groups (n = 10), according to the resin used. G1 (control): Filtek Z350 (3M/ESPE); G2: Filtek Bulk Fill flow (3M/ESPE); G3: Surefill SDR (Dentsply); G4: X-tra (Voco). These were further subdivided into subgroups according to the strategy used to apply the adhesive (self-etch technique and conventional). After storage for 24 hours in an oven (37 °C), the samples were submitted to the thermocycling test (500 cycles: 5 °C/55 °C). They were later waterproofed, immersed in Basic Fuchsin (0.5%) and sectioned in the mesial-distal direction for evaluation using a stereo magnifying glass at 40X (Coleman) Scores from 0 to 3 were assigned according to the microinfiltration observed. The Mann-Whitney and Kruskal-Wallis tests, with a significance level of 5%, were used for statistical analysis. Result: There was no statistically significant difference between the Bulk Fill resins when the total acid-etching technique was used. Only the Filtek Bulk fill flow resin presented statistically significant results when the application of the adhesive system strategy was considered, with worse results, in relation to other groups, when it the self-etching strategy was considered. Conclusion: The degree of leakage of the bulk fill resins studied, in class II cavities, was not influenced by the method of application of the adhesive system (conventional or two-step self-etching bonding agent), except for the Filtek Bulk fill flow.

Introdução: Apesar dos avanços e inovações na odontologia restauradora, a microinfiltração continua sendo um dos principais problemas nessa área. Objetivo: Avaliar in vitro a microinfiltração marginal das resinas Bulk Fill em cavidade classe II, com terminação cervical em dentina. Material e método: Cavidades padronizados na mesial e distal foram elaboradas em quarenta dentes molares superiores e alocados aleatoriamente em quatro grupos (n=10), de acordo com a resina usada: G1 (controle): Filtek Z350(3M/ESPE); G2: Filtek Bulk Fill flow (3M/ESPE); G3: Surefill SDR (Dentsply); G4: X-tra base (Voco), sendo estes subdivididos em subgrupos considerando a estratégia adesiva aplicada (autocondicionamento e convencional). Após 24h de armazenamento em estufa (37 °C), as amostras foram submetidas ao teste de termociclagem (500 ciclos: 5 ºC/55 ºC). Posteriormente foram impermeabilizados, imersos em Fucsina Básica (0,5%) e seccionados no sentido mésio-distal para avaliação com lupa estereoscópica 40X (Coleman), sendo atribuído escores de 0 a 3 de acordo com a microinfiltração observada. Para análise estatística foi aplicado o teste Mann-Whitney e o Kruskal-Wallis com nível de significância de 5%. Resultado: Não houve diferença estatística significante entre as resinas Bulk Fill, quando utilizada a técnica de condicionamento ácido total. Apenas a resina Filtek Bulk fill flow apresentou resultados estatisticamente significante quando se considerou a estrategia de aplicação do sistema adesivo, com piores resultados, em relação aos outros grupos. Conclusão: O grau de infiltração em cavidades classe II das resinas bulk fill estudadas, não foi influenciado pelo modo de aplicação do sistema adesivo (convencional ou autocondicionante), exceto para Filtek Bulk fill flow.

Durability of the adhesive cementation to the dentin substract / Durabilidade da cimentação adesiva ao substrato dentinário

ABSTRACT Objective The aim of this study was to evaluate, in vitro, the union stability of resin cements to the dental substract through microtensile bond strength (µTBS) analysis and scanning electron microscopy (SEM). Methods Fifty-four third human molars, stored in water for a short (24 hours) and long period of time (1 year) presented a flat oclusal superficial dentin. The teeth were distributed in six different groups: G1- Panavia F2.0/Kuraray; G2- RelyXUnicem/3M ESPE; G3- G-Cem/GC; G4- Biscem/ Bisco; G5- Panavia F2.0/Kuraray without pre-treatment and G6- Multilink Sprint/Ivoclar-Vivadent which were adhered to its respective indirect resin composite restoration, (G1- Clearfil AP-X/Kuraray; G2- Filtek Z350/3M ESPE; G3- Gradia Direct X(tm)/GC; G4- Aelite(tm)/ Bisco; G5- Clearfil AP-X/Kuraray; G6- Tetric Ceram/ Ivoclar-Vivadent). The resin blocks were cemented and the sticks were obtained by tooth, with an area of adhesive interface of 0,8mm² (±0,2). Results The mean values, submitted to Mann-Whitney and Kruskal-Wallis tests (α = 5%) were in MPa after 24 hours: G1 = 9.66 (A), G2 = 13.37 (A); G3 = 15.89 (A); G5 = 4.18 (B); G6 = 11.01 (A) and after 1 year: G1 = 9.75 (A), G2 = 11.73 (A); G3 = 20.10 (B); G5 = 6.80 (A); G6 = 21.09 (B). All G4 group presented pretest failures. Conclusion During the one year period, with the exception of BisCem, the self-adhesive resin cements were a favorable alternative for the adhesive cementation, standing out among these, the G-Cem and Multilink Sprint.

RESUMO Objetivo Avaliar, in vitro, a estabilidade da união de cimentos resinosos ao substrato dental através da resistência de união e análise em microscopia eletrônica de varredura (MEV). Métodos Cinquenta e quatro terceiros molares humanos, armazenados em água por um curto (24 horas) e longo período de tempo (1 ano), tiveram a face oclusal removida expondo a superfície dentinária. Os dentes foram distribuídos em seis grupos distintos: G1- Panavia F2.0 / Kuraray; G2- RelyX Unicem / 3M ESPE; G3- G-Cem / GC; G4- BisCem / Bisco; G5- Panavia F2.0 / Kuraray sem pré-tratamento e G6- Multilink Sprint / Ivoclar-Vivadent que foram aderidas ao seu respectivo restaurações de resina composta indireta, (G1- Clearfil AP-X / Kuraray; G2- Filtek Z350 / 3M ESPE; G3- Gradia Direct X (tm) / GC; G4- Aelite (tm) / Bisco; G5- Clearfil AP-X / Kuraray; G6- Tetric Ceram / Vivadent Ivoclar-). Os blocos de resina foram cimentados e foram obtidos palitos, com área de interface adesiva de 0,8mm² (± 0,2). Resultados Os valores médios, submetidos à Mann-Whitney e Kruskal-Wallis testes (α = 5%) foram em MPa após 24 horas: G1 = 9,66 (A), G2 = 13,37 (A); G3 = 15,89 (A); G5 = 4,18 (B); G6 = 11,01 (A) e depois de 1 ano: G1 = 9,75 (A), G2 = 11,73 (A); G3 = 20,10 (B); G5 = 6,80 (A); G6 = 21,09 (B). O grupo todo G4 apresentou falhas pré-teste. Conclusão Durante o período de um ano de investigação, os cimentos de resinosos auto-adesivos, exceto o Bis Cem, eram uma alternativa favorável para a cimentação adesiva, destacando-se entre estes o G-Cem e Multilink Sprint.

Universal cements: dual activated and chemically activated.

Objective: The aim of the present study was to assess the bond strength of universal cements cured either dually or chemically only. Methods: Three cements were assessed using different types of application: dual activated (DA) or chemically activated (CA). In total 80 dentin blocks were used, obtained through the enamel wear of the lingual and buccal surfaces of bovine incisors. Standard cone-shaped cavity preparations were created using diamond burs. Subsequently, indirect restoration blocks were designed with Filtek Z350 (3M ESPE) composite resin. The teeth were divided into two groups (DA and CA) and then subdivided into four subgroups (n = 10) prior to cementation with the respective products: Duo-Link (Bisco); RelyX Ultimate (3M ESPE); Nexus 3 (Kerr) and conventional RelyX ARC (3M ESPE) as the control. The cementation in the PA group was applied following the manufacturer's instructions. The CA group was cemented in a darkroom to avoid exposure to light. They were stored in distilled water at 37 °C for 24 h and submitted to the push-out test. Data were analyzed by two-way ANOVA and Tukey's post-hoc test (p < .05). Results: The greatest bond strength results were obtained for photoactivated universal cements. Conclusion: Chemical activation is not sufficient to ensure acceptable bond strength.

APRIMORANDO A ESTÉTICA COM COROAS "METAL FREE": RELATO DE CASO / Improving the aesthetics with "METAL FREE": a case report

O Introdução: A busca pela estética está cada vez mais presente no dia-a-dia do cirurgião-dentista. Devido a isto a preocupação dos pacientes com as restaurações, especialmente em dentes anteriores, tem aumentado cada vez mais. A utilização de coroas livre de metal responde positivamente a essa preocupação estética. Objetivo: Este artigo tem como objetivo apresentar um relato de caso clínico que mostra a reabilitação de dois dentes com o uso de coroas puras de cerâmica IPS E-MAX. Relato de Caso: O paciente procurou atendimento odontológico se queixando da estética dos elementos 24 e 25, após constatar que os elementos haviam tratamento endodôntico adequado e já haviam núcleos metálicos fundidos (duracast) em condições satisfatórias, foi selecionado o sistema cerâmico dissilicato de lítio IPS E-max (Ivoclar Vivadent), para a confecção das coroas. Conclusão: As coroas em cerâmica metal-free, apresentam-se como uma excelente alternativa restauradora, desde que o protocolo clínico de utilização seja corretamente seguido.clínico, é imprescindível ao profissional fazer opção por parâmetros mais científicos, favorecendo a função mesmo que a estética fique comprometida.

Introduction: The search for aesthetic is becoming increasingly present on the day of the dentist. Due to this the concern of the pacients with restorations, especially in anterior teeth, is increasing more and more. The use of metal free crowns responds positively to this aesthetic concern. Objective: This article aims to present a case report showing the rehabilitation of two teeth using pure ceramic crowns IPS E-MAX. Case report: The patient sought dental care complaining of aesthetic elements 24 and 25, after noting that the elements had appropriate endodontic treatment and had already molten metallic cores (gold /duracast) in satisfactory condition, was chosen lithium disilicate ceramic system IPS E-max (Ivoclar Vivadent), for the manufacture of ceramic crown. Conclusion: Ceramic crowns metal free, are presented as an excellent alternative restoration since the clinical protocol is followed correctly.

Sistema adesivo universal e cimento resinoso universal em coroas cerâmicas: relato de caso / Universal adhesive system and resin cement for all-ceramics crowns: case report

A demanda por restaurações estéticas que mimetizem os dentes naturais é crescente, e as cerâmicas são uns dos materiais que melhor reproduzem as características do esmalte e da dentina. A cimentação adesiva é considerada uma etapa crítica, complexa e sensível. O cimento resinoso RelyX™ Ultimate (3M Espe) apresenta polimerização dual, excelente aderência e fácil manipulação. Sua associação com o Single Bond™ Universal (3M Espe) o torna um material prático e de fácil utilização, pois o adesivo funciona como agente de pré-tratamento para todo tipo de material restaurador, além de possuir ativador de polimerização química, o DCA (3M Espe). O objetivo deste trabalho é ressaltar, por meio de um relato de caso, as vantagens do uso do Cimento RelyX Ultimate associado ao Sistema Adesivo Single Bond Universal, na cimentação de uma coroa cerâmica IPS E-max (Ivoclar Vivadent) e de uma coroa metalocerâmica IPS d’Sign (Ivoclar Vivadent)...

The demand for esthetic restorations that mimic natural teeth is increasing, and ceramic materials best reproduce the characteristics of enamel and dentin. Adhesive cementation is considered a critical, complex and sensitive step. A dual-cure resin cement with excellent bonding properties and easy handling was used (RelyX™ Ultimate, 3M ESPE), associated with an universal adhesive system (Single Bond™ Universal, 3M ESPE). This adhesive system is user-friendly and acts as a pretreatment agent for all types of restorative material, in addition to have a chemical activator (DCA by 3M ESPE). The aim of this case report is to highlight the advantages of using an universal cement associated with an adhesive for cementation of all-ceramic crowns (IPS E-max and IPS d’Sign, Ivoclar Vivadent)...