Interdisciplinary treatment of cervical lesions.

Soft tissue grafting is an integral part of treatment of cervical lesions due to the common lack of adequate attached gingiva and root exposure associated with these lesions. Complete root coverage is a predictable outcome for Miller Class I and II recession defects, and partial root coverage can be achieved in Miller Class III defects. In the esthetic zone, it is desirable to cover as much of the root as possible, and all sites require an adequate zone of attached gingiva, especially adjacent to a restoration. Restorations are required for cervical lesions with excessive depth and significant involvement of the enamel, but they should be avoided where the lesion is shallow and the enamel involvement is minimal. Of course, some sites will require both soft-tissue grafting and placement of a restoration. An interdisciplinary approach to treating cervical lesions will create the most biologically appropriate, stable, and esthetic outcome. Establishing the appropriate tooth form first in treatment planning and sequencing will determine the gingival level and extent of periodontal procedures necessary to achieve the desired outcome.

Finishing and polishing criteria for minimally invasive composite restorations.

To achieve the benefits that composite restorations can provide, it is incumbent on dentists to understand the importance of proper finishing and polishing techniques and how to incorporate them appropriately into everyday practice. A smooth surface finish is clinically necessary because the presence of surface irregularities from poor finishing and polishing can lead to staining, plaque retention, gingival irritation, recurrent caries, abrasiveness, wear kinetics, and tactile perception by the patient. However, finishing and polishing procedures for direct composite restorations are technique- and material-sensitive. This article describes the proper composite material placement considerations, as well as finishing and polishing techniques and materials, for providing highly esthetic, long-lasting restorations. By incorporating such protocol into their everyday practices, dentists can increase the long-term esthetic and plaque-resistant predictability of direct composite restorations.

Why do we polish? Part Two.

What does polishing oral hard tissues and restorations accomplish? The two parts of this review will describe the effect of polishing on various restorative materials and teeth; the development of biofilm and adherence of plaque to teeth and restorations; the effects of unpolished versus polished surfaces on gingival health and longevity of restoration; and techniques for polishing various restorative materials.

Effect of particle diameter on air polishing of dentin surfaces.

We examined the abrasiveness of glycine powders with particle diameters of 63 and 100 mum by measuring the depth and volume of defects produced during air polishing of human dentin. A total of 36 extracted human teeth were embedded in acrylic resin. The resin blocks were polished until the dentin surfaces were exposed. The nozzle of an air polisher was mounted 4 mm from the dentin surface, and the dentin surface was treated for 5 s at one of two angles of incidence (45 degrees or 90 degrees). Three materials were used in the polishing process: NaHCO(3) powder with a mean particle diameter of 100 microm (Handy Jet Powder), glycine powder with a mean particle diameter of 63 microm (Handy Jet Powder PMTC), and glycine powder with a mean particle diameter of 100 microm (Handy Jet Powder Recall). The defect depth at both angles was significantly deeper after treatment with Handy Jet Powder or Handy Jet Powder PMTC. The defect volume was the greatest with Handy Jet Powder, followed by Handy Jet Powder PMTC, and Handy Jet Powder Recall. The larger diameter glycine powder resulted in less damage to the dentin.

Surface roughness of three different glass ionomers with our without finishing/polishing: an in vitro study

Purpose: This study aimed to compare the surface roughness among 3 types of glass ionomers (GI) before (no polishing) and after polishing with three different materials. Methods: 20 discs for each GI group were obtained (A-Ionolux; B-IonoStar Plus; C-Ketac). Those groups were subdivided according to finishing and polishing: subgroups 1 (control) - no polishing, 2 - polishing with prophylactic brush and pumice paste, 3 - Enhance tips with water, and 4 - Sof-Lex system with Easy Glaze and polymerization. For each disc face, the total distance analyzed was 2.88cm (6x48mm). Then, the roughness was compared using the Kruskal-Wallis with Bonferroni test, with significant data if p<0.05. Results: The mean of roughness within Group A was lower for subgroup 4 (1.07±0.54 µm) and higher for subgroup 2 (2.33±1.17 µm). Within group B, B4 had the lowest mean of roughness (0.93±0.38 µm) and B2 (1.24 ± 0.78 µm) the highest roughness. Within group C, Group C4 had the lowest mean roughness value (0.84±0.54 µm), and C3 had the highest mean (2.48±1.05 µm). After polishing, subgroup 4 had the general lowest values for surface roughness (mean Ra 0.95), followed by subgroup 1 (Ra=1.27), subgroup 2 (Ra=1.89), and higher values for subgroup 3. All intragroup analysis for A, B, and C were statistically significant. Group A presented the highest roughness (p<0.05), and no statistically significant evidence existed between groups B and C (p>0.05). Conclusion: The reduction of the roughness of the materials is dependent on their composition and the polishing and finishing techniques applied.

Estabilidade de cor de diferentes sistemas cerâmicos fresados no CAD/CAM e polidos com diferentes métodos / Color stability of different ceramic systems milled in CAD/CAM and polished with different methods

A descoloração ou perda de translucidez dos materiais cerâmicos usados em odontologia ainda hoje é um problema, especialmente pelo comprometimento estético. Com o objetivo de comparar a estabilidade de cor, blocos de dissilicato de lítio (IPS e.max CAD HT) e de silicato de lítio reforçado com zircônia (Vita Suprinity HT) fresados no desenho de um disco com dimensões de 1,5 × 7 × 12 mm3 (n = 120) foram preparados usando 3 procedimentos de acabamento de superfície: glaze, polimento mecânico e coloração externa e glaze. Em seguida, cada grupo foi dividido em 2 subgrupos de armazenamento, chá preto e café (n = 10/grupo). As mensurações de cor foram medidas com espectrofotômetro (VITA Easyshade) no estágio inicial e após 1 semana, 2 semanas, 1 mês, 2 meses de armazenamento. As alterações de cor (ΔE) foram calculadas e analisadas estatisticamente usando ANOVA (α < 0,05). Observamos que, para ambos os materiais cerâmicos, o procedimento de glaze apresentou valores de mudança de cor estatisticamente menores do que os outros grupos (p < 0,05) após o armazenamento em ambas as bebidas. Os grupos de dissilicato de lítio apresentaram valores de alteração de cor estatisticamente menores em relação aos grupos de silicato de lítio reforçados com zircônia. Conclui-se que, o glaze sozinho levou a uma maior estabilidade de cor em relação ao polimento mecânico e coloração externa o dissilicato de lítio apresentou maior estabilidade de cor em comparação com o silicato de lítio reforçada com zircônia.

The discoloration or loss of translucency of ceramic materials used in dentistry is still a problem today, especially due to aesthetic compromise. In order to compare color stability, lithium disilicate (IPS e.max CAD HT) and zirconia-reinforced lithium silicate (Vita Suprinity HT) blocks were milled into a disc design with dimensions of 1.5 × 7 × 12 mm3 (n = 120). The specimens were prepared using 3 surface finishing procedures: glaze, mechanical polishing and external staining and glaze. Then, each group was divided into 2 storage subgroups, black tea and coffee (n = 10/group). Color measurements were measured with a spectrophotometer (VITA Easyshade) at the initial stage and after 1 week, 2 weeks, 1 month, 2 months of storage. Color changes (ΔE) were calculated and statistically analyzed using ANOVA (α < 0.05). We observed that, for both ceramic materials, the glaze procedure presented statistically lower color change values ​​than the other groups (p < 0.05) after storage in both beverages. The lithium disilicate groups showed statistically lower color change values ​​than the zirconia-reinforced lithium silicate groups. It is concluded that, glaze alone led to greater color stability compared to mechanical polishing and external staining, lithium disilicate showed greater color stability compared to zirconia-reinforced lithium silicate.

Efeito dos diferentes tipos de polimento sobre a rugosidade de superfície de uma resina acrílica comercial quimicamente ativada: estudo in vitro / Effect of different types of polishing on the surface roughness of a chemically activated commercial acrylic resin: an in vitro study

Objetivo: avaliar in vitro o polimento sobre resina acrílica quimicamente ativada (RAQA), por meio da rugosidade de superfície (Ra). Materiais e Método: Foram confeccionadas 40 amostras de RAQA, com dimensões de 10 a 10 x 2 mm, e foram divididas em quatro grupos (n=10): ausência do acabamento (AA); Ausência de polimento (AP); Polimento químico (PQ); Polimento com borrachas siliconadas + Escovas (PM). Os espécimes foram avaliados no quanto a rugosidade média (Ra) antes e após o envelhecimento em água destilada em uma estufa por 60 dias. Três medições de Ra (µm), na horizontal foram realizadas e calculada uma média para cada espécime. Os dados foram analisados de forma descritiva e inferencial, ANOVA de medidas repetidas e teste de Tukey com nível de significância de 5%. Resultados: Inicialmente, o grupo AA teve os menores valores de Ra e o grupo AP os maiores valores de rugosidade, com média e desvio padrão respectivamente 0,17 (±0,11) e 0,52 (±0,10). Após o envelhecimento, o grupo AA teve as menores médias e o grupo PQ os maiores valores de Ra, sendo 0,38 (±0,20) e 1,33 (±0,32), respectivamente. Os resultados evidenciaram diferença estatística significante quando as amostras foram submetidas ao acabamento com brocas. Conclusão: A RAQA necessita de polimento após acabamento com brocas, uma vez que a ausência de polimento comprometerá a lisura de superfície do material.(AU)

Objective: to evaluate in vitro polishing on chemically activated acrylic resin (RAQA), using surface roughness (Ra). Materials and Method: 40 RAQA samples were made, measuring 10 to 10 x 2 mm, and divided into four groups (n=10): absence of finishing (AA); Lack of polishing (AP); Chemical polishing (PQ); Polishing with silicone rubbers + Brushes (PM). The specimens were evaluated for their average roughness (Ra) before and after aging in distilled water in an oven for 60 days. Three horizontal Ra (µm) measurements were taken and an average was calculated for each specimen. Data were analyzed descriptively and inferentially, using repeated measures ANOVA and Tukey test with a significance level of 5%. Results: Initially, the AA group had the lowest Ra values and the AP group the highest roughness values, with mean and standard deviation respectively 0.17 (±0.11) and 0.52 (±0.10). After aging, the AA group had the lowest averages and the PQ group the highest Ra values, being 0.38 (±0.20) and 1.33 (±0.32), respectively. The results showed a statistically significant difference when the samples were finished with drills. Conclusion: RAQA requires polishing after finishing with drills, as the lack of polishing will compromise the surface smoothness of the material.(AU)

Restoring the interproximal zone using the proximal adaptation technique--Part 2.

In this era of modern adhesive dentistry, clinicians are still faced with challenges from microleakage, recurrent decay, and sensitivity. Many of the challenges are a result of using yesterday's restorative techniques and principles with the new formulations of biomaterials. Procedures such as the proximal adaptation and the oblique layering techniques offer modifications to the nonadhesive principles discussed in Part I (The Compendium, December 2004), while providing the patient and clinician with the 3 primary objectives of restorative dentistry: prevention, preservation, and conservation. Using stratification techniques and thorough adhesive protocol as illustrated in this article allows clinicians to provide restorations that have improved physical characteristics while reducing the effects of polymerization shrinkage. Other benefits of these adhesive procedures include enhanced chromatic integration, ideal anatomical form and function, optimal proximal contact, improved marginal integrity, and longer lasting directly placed composite restorations.

Contaminated implant surfaces: an in vitro comparison of implant surface coating and treatment modalities for decontamination.

The relationship between implant surfaces and decontamination treatments was studied in vitro to determine which implant surfaces were most effectively decontaminated, and which treatment was most effective for treating a particular implant surface. The implants used in the study were press fit cylindrical titanium units with machined, plasma sprayed, and hydroxyapatite-coated surfaces. Radioactive endotoxin (125I-LPS) was prepared from Porphyromonas gingivalis (ATCC 33277). Implants were coated with 125I-LPS and treated by burnishing with a cotton pellet soaked in water, citric acid solution (CA), or 0.12% chlorhexidine (CHX); or treated with an air-powder abrasive (AIR). Radioactivity was determined after each of two treatment cycles. The results for each implant surface were analyzed using ANOVA to determine differences between treatments. The remaining 125I-LPS after two treatment cycles were: for machined implants AIR < CA, with AIR = water = CHX and water = CHX = CA; for plasma sprayed implants AIR < water = CHX = CA; for hydroxyapatite implants AIR = CA < water < CHX. In evaluating treatment modalities, it was found that machined implants were decontaminated more effectively than the other surfaces by all treatments; the exception was citric acid treatment which was equally effective on either machined or hydroxyapatite surfaces. These results indicate that machined implants (without surface coating) are most readily decontaminated by a variety of methods; this characteristic should be considered, since long-term success of implants may involve treating periimplantitis. Further, the results indicate that air abrasives are effective for decontaminating implant surface, with the exception that hydroxyapatite coated surfaces can be treated equally with air abrasives or citric acid.

Finishing and polishing of direct posterior resin restorations.

UNLABELLED: Direct composite resin materials have revolutionized the delivery of minimally invasive treatment in the posterior region. Contemporary resin formulations provide improved strength, wear resistance, and aesthetics. Microhybrid formulations have also been associated with enhanced polishability. Development of an optimal surface polish in turn reduces stain and plaque accumulation, minimizes wear, and enhances the appearance of the definitive restoration. This article presents a simplified technique and protocol for finishing and polishing composite resin materials following restoration of the posterior region. LEARNING OBJECTIVES: This article discusses techniques and a protocol for finishing and polishing posterior direct resin restorations. Upon reading this article, the reader should: Understand the clinical protocol necessary to create direct posterior resin restorations that require minimal finishing. Be able to select appropriate instrumentation for direct posterior resin finishing and polishing procedures. Understand the importance of correct finishing and polishing on plaque accumulation, stain resistance, and wear resistance.

Practical posterior composites. Efficient placement and predictable results.

Certainly, we could spend more time matching shades, applying characterizations, placing secondary anatomy, and even finishing. However, if posterior composite restorations are to be a viable alternative to amalgam in appropriate cases, we must accomplish efficient and predictable placement so that fees for the two types of restorations are somewhat in line. Contact must be solid, sensitivity must be kept to a minimum, and placement and finishing must be fairly simple and organized. If the problems with posterior composites aren't kept to a minimum, all of dentistry will suffer. Our contacts are excellent most of the time, but occasionally we need to redo a "light" one. Our best estimate is that about one in 100 fillings that had no preoperative symptoms needed some postoperative care after restoring. Usually these complaints are corrected by occlusal adjustment, and very rarely by replacing the restoration. We have not yet made a perfect restoration in our practice--we are still trying.

Influência dos sistemas de polimento na rugosidade de superfície da resina acrílica autopolimerizável / Influence of polymer systems in self-curing acrylic resin surface roughness

A confecção de restaurações provisórias constitui etapa importante para o sucesso das reabilitações com próteses fixas. Para melhores resultados, é fundamental que estas restaurações tenham adequada lisura superficial, a fim de evitar o acúmulo de biofilme, bem como suas consequências. Objetivou-se avaliar a influência dos sistemas de polimento na rugosidade de superfície das resinas acrílicas autopolimerizáveis. Foram confeccionados 50 discos (10×2 mm) de 3 diferentes resinas acrílicas autopolimerizáveis comumente utilizadas em consultórios odontológicos (150 discos no total). Estes foram aleatoriamente divididos em 5 grupos (n=10) de acordo com o tratamento de superfície que receberam: (C) controle ­ broca de tungstênio de corte cruzado médio, (E) sistema de polimento Exa Technique (Edenta AG), (EP) sistema de polimento Exa Technique + pasta diamantada, (V) Kit de polimento Viking (KG Sorensen) e (VP) Kit de polimento Viking + pasta diamantada. A rugosidade de superfície (Ra) foi verificada através de um rugosímetro por meio de quatro leituras em diferentes direções dos discos e, em seguida, calculadas as médias aritméticas. Independente da resina acrílica, os maiores valores de Ra foram observados para os discos tratados apenas com a broca de tungstênio e não foram observadas diferenças estatísticas significantes entre os sistemas de acabamento/polimento utilizados (p<0,05). Independente dos sistemas, não houve diferença estatística significante de Ra entre as resinas acrílicas testadas neste estudo (p<0,05). Os sistemas de acabamento/polimento influenciaram na rugosidade de superfície das resinas acrílicas autopolimerizáveis testadas. A adição da pasta diamantada à estratégia de polimento não proporcionou melhoria de Ra (AU).

The preparation of temporary restorations constitutes an important step for the success of rehabilitations with fixed prostheses. For best results, it is essential that these restorations have adequate superficial smoothness in order to avoid biofilm accumulation, as well as its consequences. This study aimed to assess the influence of polishing systems in self-curing acrylic resin surface roughness. Fifty discs (10×2 mm) of 3 different self-curing acrylic resins commonly used in dentistry were made (150 discs in total). These were randomly divided into 5 groups (n=10) according to the surface treatment they received: (C) control ­ medium cross-cut tungsten drill; (E) Exa Technique polishing system (Edenta AG); (EP) Exa Technique polishing system + diamond paste; (V) Viking polishing kit (KG Sorensen); and (VP) Viking polishing kit + diamond paste. The surface roughness (Ra) was verified through a rugosimeter by means of four readings in different directions of the disks and then the arithmetic averages were calculated. Regardless the acrylic resin type, the highest values of Ra were observed for the disks treated only with tungsten drill, and no statistically significant differences were observed between the finishing/polishing systems used (p <0.05). Regardless of the systems, there was no statistically significant difference of Ra between the acrylic resins tested in this study (p <0.05). Finishing/polishing systems influenced the surface roughness of the self-curing acrylic resins tested. Addition of the diamond paste to the polishing strategy did not provide Ra improvement (AU).

Influência do polimento e tipo de solução extrínseca na pigmentação de restaurações de resina composta / Influence of the dental polishing and type of extrinsic solution in the pigmentation of composite resin restorations

Objetivo: avaliar a pigmentação de restaurações de resina composta (RC) submetidas a diferentes métodos de polimento. Materiais e método: foram realizadas restaurações de RC classe V em 80 dentes bovinos, corpos de prova, divididos em dois grupos experimentais: G1, polimento com Ultra-Gloss, e G2, polimento com um sistema que utiliza uma ponta siliconada impregnada com abrasivo, Enhance. Após, todos os grupos experimentais foram submetidos a soluções pigmentantes de café, chimarrão e refrigerante, 2 vezes ao dia, por 5 minutos, num período de 15 dias. Os corpos de prova foram analisados pela coloração da RC através de um colorímetro utilizando o sistema CIE-Lab. Aplicou-se a análise de variância seguida do método de comparação múltipla de Tukey, quando observada diferença significativa entre os corpos de prova. Resultados: os resultados mostraram que houve diferença estatística nos valores de médios (valor-p < 0,05), sugerindo o café com variação mais elevada; também para as variações entre a condição experimental (valor-p < 0,05), com exceção de delta a (valor-p = 0,817). Conclusão: o tipo de método para polimento de restaurações em RC não apresenta associação significativa com a pigmentação do material, sendo que esta está relacionada com o tipo da solução corante e com o tempo de exposição do compósito às pigmentações. (AU)

Objective: to evaluate the pigmentation of composite resin restorations submitted to different polishing methods. Materials and method: Class V composite resin restorations were performed on 80 bovine teeth, specimens, and divided into two experimental groups: G1-polishing with Ultra-Gloss and G2-polishing with a system using a silicon tip impregnated with abrasive, Enhance. Afterwards, all the experimental groups were submitted to pigmenting solutions of coffee, chimarrão and refrigerante, 2 times a day, for 5 minutes, in a period of 15 days. The specimens were analyzed by coloring the composite resin using a colorimeter using the CIE-Lab system. The analysis of variance was applied followed by Tukey's multiple comparison method when a significant difference was observed between the test specimens. Results: The results showed that there was statistical difference in the mean values (p-value <0.05), suggesting coffee with the highest variation; (p-value <0.05), with the exception of delta a (p-value = 0.817). Conclusion: The type of method for polishing restorations in composite resin does not present a significant association with the pigmentation of the material, which is related to the type of the dye solution and the time of exposure of the composite to pigmentation. (AU)

Analysis of enamel and material wear by digital microscope: an in-vitro study

Abstract: The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.

Evaluation of Surface Roughness of Monolithic Zirconia after Using Different Polishing Kits

Objective: To evaluate the effect of different kits to polish monolithic zirconia on its surface roughness. Material and Methods: Five samples were fabricated using zirconia blocks. Each sintered block was divided into four areas of equal size and each area was subjected to a specific surface treatment according to the four groups of the study: GC: no surface treatment, GG: unidirectional grinding with high speed tapered bur under refrigeration, GP1: wear similar to GG followed by polishing with zirconia polishing kit Kenda at the same wear direction, and GP2: wear similar to GG followed by polishing with zirconia polishing kit Diacera at the same wear direction. Qualitative and quantitative analyses of ceramic topography and roughness were performed using a digital optical profilometer, and Roughness measurements were performed using two parameters (Ra and Rz: arithmetical mean of the absolute values of the surface departures and of the five highest peaks and valleys, respectively). Scanning electron micrographs of each ceramic surface were obtained to illustrate sample roughness. The means of each group were analyzed by 1-way ANOVA followed by Tukey's test. Results: Morphological analysis showed that polishing kits provided the same pattern of a smooth surface. To statistical analysis, this study showed that different polishing kits influenced zirconia roughness for both Ra and Rz after surface wear (p < 0.05) with both situations improved the surface roughness observed immediately after zirconia sintering. Conclusion: According to the results, both polish kits resulted in a surface texture within acceptable clinical parameters.

Efeito de diferentes sistemas de polimento na rugosidade superficial e brilho de resina composta: análise clínica e laboratorial / Effect of different polishing systems on the surface roughness and gloss of resin composite: Clinical and in vitro analysis

Este trabalho foi composto por dois estudos: um in vitro e um clínico randomizado e duplo-cego. O objetivo deste estudo foi compreender o efeito de diferentes sistemas de polimento na rugosidade e brilho superficial da resina composta avaliados em diferentes períodos. Estudo Laboratorial: Cinquenta espécimes de resina composta (Amaris, VOCO) foram confeccionados e divididos em dois grupos variando o sistema de polimento utilizado SFE: Sof-Lex Espiral (3M ESPE) - dois passos e DMT: Dimanto (VOCO) - passo único. Análises de brilho espectral, brilho subjetivo e rugosidade superficial foram realizadas, imediatamente após o polimento, após seis meses e após um ano. O teste de Kolmogorov-Smirnov foi utilizado para verificar a normalidade dos dados. Para o brilho espectral foi utilizada análise de variância de medidas repetidas (ANOVA)(p<0,05) seguida do teste de Tukey (α = 0,05) que demonstraram que o grupo SFE apresentou maior brilho e ainda, ambos os grupos obtiveram valores de brilho menores após seis meses. Como os dados de brilho subjetivo e rugosidade superficial não apresentaram normalidade, foram aplicados os testes Mann-Whitney U e Frideman (α = 0,05). Para o brilho subjetivo, SFE apresentou maiores valores do que DMT quando avaliado após o polimento, porém, em seis e doze meses não houve diferença estatisticamente significante entre eles. Quanto a rugosidade superficial não houve diferenças significantes entre os dois sistemas de polimento nem quanto a fator tempo e nem na interação desses fatores. Estudo Clínico: Cinquenta facetas em resina composta (Amaris, VOCO) foram realizadas em pacientes e divididas em dois grupos, dependendo do sistema de polimento utilizado e avaliadas quanto a brilho subjetivo por pacientes e examinadores, quanto a rugosidade superficial em rugosímetro através de réplicas em resina epoxi e pelo paciente através da Escala Análoga Visual (EAV) e percepção pela língua comparando a um dente natural (controle), após o polimento e após seis meses. Os resultados foram submetidos à análise estatística para verificar a normalidade dos dados. Para a analise com EAV não foi encontrada diferença estatística. Para a percepção da textura da superfície, não houve diferença após o polimento, demonstrado pelos testes Exato de Fischer e Qui-Quadrado. Após seis meses o grupo DMT percebeu diferença de rugosidade, onde os pacientes consideraram o dente da faceta mais liso. Em relação a percepção de brilho pelo paciente, o teste Qui-quadrado demonstrou que não houve diferença entre os grupos. Quanto a avaliação pelo profissional, os testes de Mann-Whiteney e Wilcoxon demonstraram que para o grupo após o polimento, sistema DMT apresentou maiores valores de brilho do que SFE e ambos perderam brilho após seis meses. Quanto a rugosidade os testes de Mann-Whiteney e Wilcoxon demonstraram que o grupo DMT apresentou menores valores enquanto SFE apresentou maiores valores em seis meses. Os resultados da avaliação subjetiva realizada pelos profissionais foram bem próximos a dos pacientes, sendo uma alternativa para avaliação da satisfação do paciente com o tratamento recebido(AU)

This research was composed of two studies: an in vitro and a double-blind randomized clinical study. The aim of the research was to understand the effect of different polishing systems on the surface roughness and gloss of resin composite measured in different periods of time. In vitro study: Fifty specimens of composite resin (Amaris, VOCO) were made and divided into two groups according to the polishing system used SFE: Sof-Lex Spiral (3M ESPE) - two steps and DMT: Dimanto (VOCO) - single step. Spectral and subjective gloss and surface roughness analysis were performed at baseline (right after polishing), after six and twelve months. The Kolmogorov-Smirnov test was used to verify the normality of the data. For spectral gloss analysis repeatedmeasures (ANOVA) followed by Tukey´s test (α = 0.05) demonstrated that SFE presents higher values than DMT and both groups obtained higher values of gloss right after polishing than after six months. As the subjective data of gloss and roughness did not present normal distribution, Mann-Whitney and Friedman tests were applied for statistical analysis (α = 0.05). SFE group presented higher values of subjective gloss than DMT just right after polishing, however for other periods evaluated, there was no statistically significant difference. Regarding the surface roughness, there were no significant differences between the two groups evaluated, neither in terms of time, nor for the interaction time and polishing systems. Clinical Study: Fifty composite veneers (Amaris, VOCO) were made on patients and divided into two groups, according to the polishing systems used and assessed for subjective gloss obtained by patients and by examiners evaluation, surface roughness measured using a profilometer and veneer epoxi resin replicas and by patients with Visual Analogue Guide (VAG) and texture perception by the tongue comparing a natural tooth (control) right after polishing and after six months. The results were submitted to statistical analysis to verify the normal distribution of the data. For the surface roughness evaluated by the patients with the VAG no statistical differences were found. For the surface texture perception, patients were not able to identify differences right after the polishing as demonstrate by Fischer Exact and Chi-Square tests, however, after six months DMT group reported differences where natural teeth were consider rougher than the veneers. Regarding the perception of gloss by the patient, the Chi-Square test showed no difference between the groups. However, some patients of DMT group described the veneers glossier than the natural tooth. For the subjective gloss assessed by the professional, the Mann-Whitney and Wilcoxon tests demonstrated that DMT system showed higher values of gloss than SFE right after polishing and at six-month evaluation both groups demonstrated lower values of gloss. For roughness, the Mann-Whitney and Wilcoxon tests showed that the DMT group had lower values of surface roughness and SFE group showed an increase after six months evaluation. The results of the subjective assessment made by professionals were close to that made by patients and was an alternative to evaluate patient satisfaction with the treatment received(AU)

Formação de fendas em restaurações de resina composta: polimento imediato versus tardio / Gap formation in composite resin restorations: immediate versus late polishing

O objetivo deste estudo foi avaliar a influência do momento da etapa de polimento, imediato ou após sete dias, na formação de fendas em restaurações de resina composta. Cavidades cilíndricas foram preparadas nas superfícies vestibulares de incisivos bovinos. Cada cavidade foi hibridizada com um dos dois sistemas adesivos: convencional (Adper Single Bond 2) ou autocondicionante (Single Bond Universal), e restaurada usando uma das três resinas compostas: nanoparticulada (Z350), micro-híbrida (P60) e bulk-fill (ONE). As cavidades restauradas foram divididas em dois subgrupos de acordo com o tempo de polimento, imediato ou postergado por 7 dias após a restauração. Por meio da combinação dos sistemas adesivos, resinas compostas e tempos de polimento, foram criados 12 grupos (n = 5). As porcentagens de fendas marginais (%FM) foram avaliadas quantitativamente com o microscópio confocal de varredura a laser. O módulo de elasticidade das resinas compostas foi obtido por meio do teste de flexão em três pontos. Os dados foram analisados por análise de variância e pelo teste de Tukey's HDS (α = 0,05). Em relação ao sistema adesivo, a %FM foi estatisticamente maior para as cavidades restauradas com Single Bond Universal (p<0,05). Com relação às resinas compostas, o resultado foi o seguinte: P60 > ONE > Z350 (p<0,05). O tempo de polimento imediato apresentou %FM estatisticamente menor que o tardio (p<0,05). P60 apresentou o maior módulo de elasticidade (p<0,05). Foi possível concluir que o polimento imediato gera menor formação de fendas em restaurações de resina composta. (AU)

The aim of this study was to analyze the influence of the polishing time, immediately or after seven days, in gap formation in composite resin restorations. Cylindrical cavities were prepared on buccal surfaces of bovine incisors. Each cavity was hybridized with one of the two adhesive systems: etch-and-rinse (Adper Single Bond 2) and self-etching (Single Bond Universal), and restored using one of the three composite resins: nanofilled (Z350), minifilled hybrid (P60) and bulk-fill (ONE). The cavities restored were divided in two subgroups according to polishing time, immediately or delayed by 7 days after specimen restoration. Through the combination of the adhesive systems, composite resins and polishing times, 12 groups were created (n=5). Percentages of marginal gaps (%MG) were quantitatively assessed with confocal laser scanning microscope. The flexural modulus of the composite resins was obtained from bar-shaped specimens submitted to three-point bending test. The data were analyzed by three-way ANOVA and Tukey's HSD test (α=0.05). Regarding adhesive system, %MG was statistically higher for cavities restored with Single Bond Universal (p<0.05). With respect to composite resins, the result was as follow: P60 > One > Z350 (p<0.05). Immediate polishing time presented statistically lower %MG than delayed one (p<0.05). P60 presented the highest flexural modulus (p<0.05). It was possible to conclude that immediate polishing generates less gap formation in composite resin restorations. (AU)

Rugosidade superficial da resina acrílica frente a quatro diferentes técnicas de polimento / Surface roughness of acrylic resin after four different polishing techniques

OBJETIVO: Avaliar a rugosidade superficial de uma resina acrílica utilizada na confecção de coroas temporárias, utilizando diferentes métodos de polimento, visto que o efetivo controle do biofilme dental é essencial para prevenção e combate de doenças, como cárie e doença periodontal. MÉTODOS: Este trabalho avaliou a qualidade de lisura superficial da resina acrílica ativada quimicamente, em corpos-de-prova elaborados especificamente para este fim, obtida por quatro diferentes técnicas de procedimentos clínicos de acabamento e polimento de coroas provisórias para prótese fixa. Cada corpo-de-prova foi submetido a um teste de rugosidade superficial no rugosímetro (Surtronic - 3, com cut off de 0,25). Também fizeram parte deste estudo duas amostras para controle positivo e negativo. RESULTADOS: Os resultados mostraram desempenho superior com maior lisura superficial da amostra polida com discos Sof Lex (3M, Sumaré, Brasil), em, relação a outras técnicas testadas. CONCLUSÃO: É fundamental a preocupação do cirurgião-dentista frente ao polimento adequado das restaurações diretas ou indiretas.

OBJECTIVE: This study assessed the surface roughness of an acrylic resin used in temporary crowns after four different polishing techniques, since effective control of the dental biofilm is essential for preventing and fighting diseases such as caries and periodontal disease. METHODS: This work assessed the surface smoothness of specimens made from self-curing acrylic resin specifically for this purpose. The specimens were finished and polished using the same techniques used on temporary crowns for fixed prosthodontics. A profilometer (Surtronic-3 with a 0.25 cut off) was then used to determine the surface roughness of each specimen. Two extra specimens were used as positive and negative controls. RESULTS: Specimens polished with Sof Lex discs (3M, Sumaré, Brasil) presented the smoothest surface. CONCLUSION: Dental surgeons need to be aware of the importance of polishing direct and indirect restorations properly.