Preservation in Young Patients of Pulp Vitality and Anatomical-Functional Restoration of the Lost Structure.

Often, young patients (≤30 years old) present with carious lesions that progress acutely, compromising a large amount of tooth structure. In these cases, a treatment to prevent the occurrence of pulp exposure and promote remineralization of caries-affected dentin is necessary to maintain healthy dental structure and allow more conservative interventions. The approach will be different when pulp exposure occurs: The therapeutic treatments will be focused on reparative dentin formation and prevention of microorganisms penetrating the pulp organ. Due to the different possible treatments that can be performed to avoid pulp necrosis and the various materials that can be used for this purpose, professionals may have some difficulties understanding all the indications for conservative pulp treatments. The objective of this article is to describe and discuss a successful pulp capping and stepwise excavation associated with restorative treatment for deep caries lesions of anterior upper teeth.

Efeito da contaminação por saliva humana na interface adesiva: resistência de união, análise de camada híbrida e conversão de sistemas adesivos / Effect of human saliva contamination on adhesive interface: bond strength, hybrid layer analysis and conversion of adhesive systems

Este estudo teve como objetivo analisar o efeito da contaminação por saliva humana na resistência de união (RU) da interface adesiva em dentina por microtração, nas características morfológicas da camada híbrida (CH) em microscopia confocal e no grau de conversão (GC) de 2 sistemas adesivos: Adper Single bond 2 (SB) e Single Bond® Universal (SU). Cento e oitenta dentes terceiros humanos hígidos foram divididos em 12 grupos (n=10), de acordo com o sistema adesivo utilizado, a presença de saliva e o tempo de armazenagem. Após o procedimento adesivo e aplicação da resina composta Filtek Z250, os dentes foram mantidos em água destilada em estufa a 37°C por 48 horas, 6 meses ou 12 meses antes de serem seccionados em palitos (0,8mm x 0,8mm, aproximadamente) para serem levados à máquina de ensaios universal Instron para os testes de microtração. Para à análise da interface adesiva em microscopia confocal de varredura a laser para verificação e mensuração de alterações internas na interface foram utilizados 60 dentes divididos em 6 grupos (n=10) de acordo com os tempos de 48 horas, 6 meses, e 12 meses respectivamente, empregando os sistemas adesivos (SB) e (SU). O efeito da presença de saliva também foi avaliado pelo grau de conversão dos adesivos, empregando-se espectroscopia de infravermelho transformada de Fourier empregando os sistema adesivos (SB) e (SU) com incorporação de saliva humana na sua composição (n=5) com concentrações 10%, 25% e 50% em vol. Para a comparação das variáveis: RU, (GC), espessura da CH, na presença de saliva e tempo de armazenamento foram utilizados os testes de Análise de Variância a três critérios e de comparações múltiplas de Tukey (p<0,05). Os valores de RU (MPa±dp: 48horas/6meses/1ano) foram: SB (43,53 ±6,0; 40,10±3,4; 38,59±5,4); SalSB (43,09±6,2; 39,86±6,6; 37,255,8); SU (42,98±4,3; 39,30±3,6; 40,44±5,7); Sal SU (44,39±4,2; 42,26±2,5; 38,26±5,7). Os Valores médios da CH (MPa±dp: 48horas/6meses/1ano) foram: SalSB (3,59±0,8; 3,59±1,0; 2,08±1,5). SalSU (1,26±0,5; 1,73±0,8; 1,07±0,3). Os valores de GC (MPa±dp: 10%/25%/50%vol) foram: SB (85,59±3,4; 49,68±12,8; 38,56±11,8); SU (85,52±3,3; 86,27±3,5; 57,82±11,1).Conclui-se, portanto, que a contaminação por saliva humana não interferiu na RU da interface dentina/resina composta após 48 horas, 6 meses e 12 meses. A morfologia da camada hibrida foi alterada pela presença da saliva nos períodos 6 e 12 meses,. O GC dos sistemas adesivos foi afetado pela presença de saliva após a polimerização imediata. Entretanto o fator tempo foi determinante para a deformação da interface dentina/resina para ambos os sistemas adesivos.(AU)

The objective of this study was to analyze the effect of human saliva contamination on bond strength of the dentin/adhesive interface, morphology of the hybrid layer by confocal microscopy and SEM analysis and degree of conversion of 2 adhesive systems: Adper Single bond 2 (SB) and Single Bond® Universal ( SU). One hundred and eighty healthy human third teeth were divided into 12 groups (n = 10), according to the adhesive system used, the presence of saliva and the storage time. After the adhesive procedure and placement of resin composite (Filtek Z250), the teeth were stored in distilled waterat 37 ° C for 48 hours, 6 months or 12 months before being cut into sticks (0.8mm x 0.8mm, approximately) to the microtensile strength tests. For the analysis of the adhesive interface in confocal microscopy of laser scanning for verification and measurement of internal interface changes, 60 teeth were used divided into 6 groups (n = 10) according to the storage time: 48 hours, 6 months, and 12 monthsand (SB) and (SU). The effect of the presence of saliva was also evaluated by the degree of conversion of the adhesives using Fourier transform infrared spectroscopy employing adhesive (SB) and (SU) systems incorporating human saliva in its composition (n = 5) with 10%, 25% and 50% vol. For the comparison of the variables: bond strength, degree of conversion, and hybrid layer thickness in the presence of saliva and storage time, the three criteria Variance Analysis and Tukey multiple comparisons tests (p <0.05) were used. The values of bond strength (MPa ± dp: 48hours / 6meses / year) were: SB (43.53 ± 6.0, 40.10 ± 3.4, 38.59 ± 5.4); SalSB (43.09 ± 6.2, 39.86 ± 6.6, 37.255.8); SU (42.98 ± 4.3, 39.30 ± 3.6, 40.44 ± 5.7); SU salt (44.39 ± 4.2, 42.26 ± 2.5, 38.26 ± 5.7). The mean values of hybrid layer thickness (MPa ± dp: 48hours / 6meses / year) were: SalSB (3.59 ± 0.8, 3.59 ± 1.0, 2.08 ± 1.5). SalSU (1.26 ± 0.5, 1.73 ± 0.8, 1.07 ± 0.3). The values of degree of conversion (MPa ± dp: 10% / 25% / 50% vol) were: SB (85.59 ± 3.4, 49.68 ± 12.8, 38.56 ± 11.8); (85.52 ± 3.3, 86.27 ± 3.5, 57.82 ± 11.1). It was therefore concluded that human saliva contamination did not interfere on bond strength of the dentin/adhesive interface after 48 hours, 6 months and 12 months. The morphology of the hybrid layer was altered by the presence of saliva after 6 and 12 months. The degree of conversion of adhesive systems was affected by the presence of saliva immediately after polymerization. However, the time factor was determinant for the dentine/resin interface deformation for both adhesive systems.(AU)

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall.

UNLABELLED: Interface integrity can be maintained by setting the composite in a layering technique and using liners. OBJECTIVE: The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations. MATERIAL AND METHODS: Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) - no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher's test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups. CONCLUSIONS: RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall

Interface integrity can be maintained by setting the composite in a layering technique and using liners. Objective The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations. Material and Methods Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher's test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups. Conclusions RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations. .

Avaliação da interface de adesão à dentina humana de um sistema restaurador adesivo à base de silorano, em cavidades de Classe I, analisados por teste de microtração e microscopia óptica / Evaluation of the interface of a silorane based restorative system to dentin of Class I cavities by microtensile bond strength test and optical microscopy

Este estudo teve como objetivo a análise da interface de adesão à dentina humana, de um sistema restaurador adesivo à base de silorano. Foram confeccionadas cavidades com 4mm X 3mm X 5mm em 40 molares humanos extraídos divididos em 4 grupos aleatoriamente: Grupos SB e SB-6m: sistema adesivo (Adper™ Single Bond) + resina composta (Filtek Z250); Grupos P90 e P90-6m: sistema adesivo (P90 System Adhesive) + resina composta (Filtek P90™). Em todos os grupos, as restaurações foram inseridas em 4 incrementos oblíquos. Após a restauração, os dentes foram seccionados em fatias de 0,8mm de espessura em uma máquina de cortes com um disco de diamante. Uma fatia de cada dente foi separada aleatoriamente para análise em microscópio óptico para verificação de fendas na interface adesiva. As demais fatias foram seccionadas em palitos (0,8mm X 0,8mm) para os testes de microtração em uma máquina de ensaios universal EMIC. Os e dos grupos SB e P90 permaneceram em água deionizada em estufa a 370C por 24 horas e os grupos SB-6m e P90-6m permaneceram em água deionizada em estufa a 370C por um período de 6 meses. Os resultados de resistência de união foram submetidos à análise de variância a 2 critérios ANOVA e a presença de fendas internas foi analisada pelo testeChi-quadrado. Houve diferença estatisticamente significante na resistência de união entre os materiais (p>0,05) e tempo de armazenagem. Quanto à presença de fendas internas, foi evidenciada sua presença em todos os grupos, sem diferença etatisticamente significante entre eles (p>0,05). Conclui-se que não houve diferença entre os sistemas restauradores á base de Bis-GMA e de silorano os 2 períodos avaliados (24h e 6 meses).

This study aimed to analyse the adhesive interface to human dentin of a silorane based adhesive system. Cavities were fabricated with 4.0 mm X 3mm X 5mm in 40 extracted human molars randomly divided into 4 groups: Groups SB and SB-6m: adhesive system (Adper™ Single Bond) + composite (Filtek Z250); Groups P90 and P90- 6m: adhesive system (P90 System Adhesive) + composite (Filtek™ P90). In all groups, the restorations were inserted in 4 oblique increments. After 24 hours, teeth were sectioned buccolingually into 0.8mm slices with diamond saw. One slice of each tooth was randomly separated for microscope analysis. The other slices were sectioned into 0.8mm X0.8mm sticks for microtensile tests in a universal testing machine EMIC. Sticks of groups SB and P90 remained in deionized water at 370C C for 24 hours and sticks of groups SB-6m and P90-6m remained in deionized water at 370C for a period of six months. After storage period . The results of bond strength were analysed by Two-way ANOVA and the presence of internal gaps was analyzed by chi-square test. There was no significant difference in bond strength between materials (p> 0.05) and storage time. Regarding the presence of internal rifts, their presence was evident in all groups, with no statistically significant difference between them (p> .05).