Effect of shade and opacity on color differences and translucency of resin composite veneers over lighter and darker substrates.

To evaluate color differences (ΔE00) and translucency parameters (TP) from mono, bi, and trilayer resin composite veneers using different opacities and shades of resin composite over lighter and darker simulated tooth-colored substrates. Mono, bi, and trilayer veneers (1.5 mm) (n = 12) were made using two shades (A1 and A2) and three opacities (enamel, body, and dentin) of resin composite over simulated lighter (A1) and darker (C4, and C4+) tooth-colored substrates. CIEDE2000 formula was used to calculate ΔE00 considering simulated tooth-colored substrate versus opacities in distinct mono, bi, and trilayer combinations of resin composite over the simulated tooth-colored substrate. The TP was calculated using color coordinates measured over standard white and black backgrounds. Differences in ΔE00 and TP values were calculated with a Three-way Analysis of Variance followed by Tukey's post-hoc test. A1E and A1B monolayer veneers showed similar TP values. Significantly higher ΔE00 values were observed over darker (C4 and C4+), and lower over lighter (A1) simulated tooth-colored substrate. Bilayer and trilayer veneers using dentin opacity provided similar ΔE00 values over the darker tooth-colored substrate. Distinct shades and opacities of resin composite layer combinations over lighter and darker tooth-colored substrates significantly affected TP and ΔE00 values. A1 shade and dentin opacity of monolayer resin composite veneers yielded higher ΔE00 values over darker tooth-colored substrates.

Sleep-related factors and orofacial pain symptoms associated with rhythmic masticatory muscle activity frequency scored by polysomnography recordings: A case-control study.

OBJECTIVE: This study aimed to evaluate the influence of the frequency of rhythmic masticatory muscle activity per hour (RMMA/h) scored by polysomnography (PSG) recordings on sleep-related factors and orofacial pain symptoms. METHODS: According to RMMA/h frequency, participants were assigned either to the control group (i.e., CRMMA, n = 40); or the case group according to high (i.e., HRMMA, n = 12) or low (LRMMA, n = 28) RMMA/h frequency. Fisher's exact (nominal variables), One-way Analysis of Variance followed by post-hoc Tukey (continuous variables) and Poisson Regression tests were used to calculate orofacial pain symptoms and sleep-related breathing, behavior, and architecture differences between controls versus cases at a significance level of 5%. RESULTS: The CRMMA differed from HRMMA and LRMMA subgroups considering orofacial pain, self-reported tooth clenching or grinding, obstructive sleep apnea (OSA), snoring, and most variables considering sleep architecture (P ≤ 0.05). Multivariate adjusted Poisson regression analysis revealed that bruxers, regardless of RMMA/h frequency, presented a significantly higher prevalence rate (PR) related to orofacial pain (PR 1.68; P = 0.025) and self-reported behavior (PR 1.71; P = 0.012). CONCLUSION: Significant differences in N1, N2 and N3 stages, arousals, arousal per hour, and sleep onset latency variables were found comparing bruxer with high or low RMMA/h frequency. Compared to controls, bruxers presented higher PR related to headache and self-reported tooth clenching or grinding.

Impact of Seniors Centers on oral health-related quality of life of older adults.

OBJECTIVE: This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS: Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics-Sense of Coherence (SOC), anxiety and depression using HADS, happiness-, and oral clinical evaluation-use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS: In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION: Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Impact of seniors centers on oral health-related quality of life of older adults

ABSTRACT OBJECTIVE This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Sense of Coherence mediates the association between temporomandibular disorders and quality of life.

OBJECTIVE: This study aimed to evaluate whether sense of coherence (SOC) mediates the association between temporomandibular disorders (TMD) and oral health-related quality of life (OHRQoL) and general quality of life (QoL) in Brazilian elders. METHODS: Informations on sociodemographic, psychological, and presence or absence of temporomandibular disorders (TMD) were collected by trained dentists among non-institutionalized elders (n = 110). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) and QoL using the WHOQOL-BREF. Structural equation modeling (SEM) was used to estimate the standardized direct effect of TMD on OHRQoL and on QoL, and the indirect effect mediated by SOC. RESULTS: Temporomandibular disorders had no direct effect on OHRQoL (coef. -0.10), whereas indirect effect mediated by SOC was noted (coef. 0.35). Regarding QoL, the indirect effect of TMD, mediated by SOC, on QoL (coef. 0.58) was higher than the direct effect (coef. 0.34). CONCLUSION: Sense of coherence mediated the effect of TMD on oral and general quality of life among elders.

Influence of light-cured luting agents and associated factors on the color of ceramic laminate veneers: A systematic review of in vitro studies.

OBJECTIVE: The luting agent plays a significant role in the appearance of ceramic laminate veneers (CLV), allowing improved/stable shade matching with adjacent teeth. A systematic review was conducted to investigate the influence of light-cured luting agents and color-associated factors aiming to draw guidelines for stable shade matching of CLV. The paper has also given an overview of the compositional characteristics of all luting agents and ceramic systems whose performance was presented herein. METHODS: A search of in vitro studies that quantitatively investigated the influence of light-cured luting agents on the color of CLV was conducted. PubMed/MedLine, Cochrane Library, SciVerse Scopus and Web of Science databases were explored until December 2017 with no year limit. Data regarding the effect of light-cured luting agent, ceramic systems, effect of background, accelerated aging and surface treatments on color change were collected. A meta-analysis was not possible due to heterogeneity of data. RESULTS: After duplicates' removal, 3630 studies were identified, 48 were selected for full-text analysis, and 21 remaining papers met the inclusion criteria and were included in this systematic review. SIGNIFICANCE: Considering the shade aspects of luting agents, translucency and value showed the greatest visible color differences for CLVs. The effect of luting agent shade on the color of veneers is greatly affected by ceramic thickness and opacity.

Inorganic filler content of resin-based luting agents and the color of ceramic veneers.

The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

Inorganic filler content of resin-based luting agents and the color of ceramic veneers

Abstract The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

Spectrophotometric analysis of clinical factors related to the color of ceramic restorations: A pilot study.

STATEMENT OF PROBLEM: Shade matching natural teeth with ceramic restorations is still an esthetic, clinical challenge. PURPOSE: The purpose of this prospective clinical study was to evaluate the influence of color-related factors on the color variation of ceramic restorations based on spectrophotometric analysis. MATERIAL AND METHODS: Color records were obtained from 11 participants who received 38 lithium disilicate restorations. CIELab color coordinates were measured with a spectrophotometer on the ceramic restoration, tooth (baseline), prepared tooth, and luted ceramics. Color variation (ΔE00) was calculated for each variable (luting agent and restoration type, tooth substrate shade, ceramic thickness, and translucency parameters) measured at baseline on the prepared tooth and after cementation of the restorations. Confidence intervals (CI) for the means (95% CI) were calculated, and the ΔE00 values and CIELab individual color coordinates were compared for each pair of variable by using the Student t test or Welch test (α=.05). RESULTS: Greater color variation values were observed between measurements obtained on the prepared tooth and luted restoration. The lower ΔE00 values were observed over darker tooth substrate measured at baseline and after luting (P=.007). CONCLUSIONS: The 3 conditions evaluated presented clinically visible color differences, highlighting the importance of clinical evaluations on the visual color acceptability limits for restorations, which are usually defined in laboratory studies. The lithium disilicate ceramic showed lower masking ability over darker tooth substrate, whereas the coordinates L*, a*, and b* were cementation-dependent.

Does the Sense of Coherence modifies the relationship of oral clinical conditions and Oral Health-Related Quality of Life?

PURPOSE: This cross-sectional study aimed to evaluate the association of demographic and clinical characteristics, Sense of Coherence (SOC), clinical conditions (number of teeth, and use of and need for dental prostheses), and Oral Health-Related Quality of Life (OHRQoL); and if the SOC modifies the relationship of clinical conditions and OHRQoL in a sample of elders. METHODS: Trained dentists assessed the participants' oral health and conducted interviews (n = 110). Information on sociodemographic conditions (sex; age at time of data collection; educational level; household income), SOC, and OHRQoL were investigated. Clinical data included use of and need for dental prostheses; number of decayed, missing, and filled teeth; and number of teeth (categorized by median). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Effect modification between SOC and each clinical oral condition on OHRQoL was tested in regression models. RESULTS: The findings of the present study showed that individuals with high SOC presented better OHRQoL, even after adjustment for sociodemographic and clinical conditions. CONCLUSION: SOC modifies the effect in the association between OHIP-14 scores and clinical conditions, and could be a protective factor in adverse conditions.

Shade of Resin-Based Luting Agents and Final Color of Porcelain Veneers.

OBJECTIVES: This study evaluated the influence of different shades of flowable resin composite used as luting agent on the final shade of porcelain veneers of different opacities over A2 and B1 simulated dental substrate. MATERIALS AND METHODS: One millimeter monolithic (enamel E1.0 or dentin D1.0) and bilayer (E0.5D0.5) porcelain discs shade A2 were paired with flowable resin composite disks (0.1 mm thick) of different shades (A1, A2, B1, white opaque - WO or IL - translucent), as veneer + luting agent (n = 10). The CIE L*a*b* color coordinates were measured with a spectrophotometer over white and black standard background, as well as over A2 and B1 simulated dental substrates. Translucency of all specimens and the shade matching of the pairs over the A2 and B1 substrates (ΔE*00 ) were calculated by Translucency Parameter and CIEDE2000 methods. Data were statistically analyzed by 95% confidence interval. RESULTS: Porcelain veneer E1.0 groups were the most translucent, while the pairs veneer + luting agent WO showed the lowest translucency, and A1, A2, B1, and IL yielded little to no differences in translucency of the pairs. The overall best shade matching with A2 substrate was observed for D1.0 veneer + WO luting agent. CONCLUSION: The opacity of the porcelain veneer paired with luting agents of different shades affected the final appearance of the restorations over distinct simulated tooth substrates. CLINICAL SIGNIFICANCE: Distinct shades of flowable resin composites used as luting agent might yield clinically visible color differences on porcelain veneers facilitating an excellent shade match with adjacent teeth. (J Esthet Restor Dent 28:295-303, 2016).

Influence of Resin Cements on the Tension Force of Cast Frameworks Made by the Technique of Framework Cemented on Prepared Abutments.

This study evaluated the tension force of cast frameworks made by the technique of framework cemented on prepared abutments using two different resin cements. Forty multi-unit abutment analogs were individually fixed with chemically cured acrylic resin inside PVC cylinders using a parallelometer. Brass cylindrical abutments were tightened to the multi-unit abutments to be used as spacers and then castable UCLA abutments were positioned above. These abutments were cast with Ni-Cr and then divided into 4 groups (n=10): cemented with RelyX U100(r); cemented with RelyX U100(r) and simulation of acrylic resin polymerization process; cemented with Multilink(r); and cemented with Multilink(r) and simulation of acrylic resin polymerization process. Abutments were cemented according to manufacturers' instructions. In a universal testing machine, tensile strength was applied in the direction of the long axis of the abutments at 1 mm/min crosshead speed until displacement of the luted abutments was obtained. The values of maximum tensile force (N) required for the displacement of the luted abutments were tabulated and analyzed statistically by one-way ANOVA with a 95% confidence level. No statistically significant difference was found among the groups (p>0.05). There was an increase in mean tension force when the specimens were subjected to the simulation of acrylic resin polymerization process, but the results did not differ statistically. Both resin cements presented positive results as regards the retention of luted abutments on their respective multi-unit abutments. Both materials may be indicated for the technique of framework cemented on prepared abutments when professionals pursuit better adaptation of implant-supported frameworks.

Influence of Resin Cements on the Tension Force of Cast Frameworks Made by the Technique of Framework Cemented on Prepared Abutments

This study evaluated the tension force of cast frameworks made by the technique of framework cemented on prepared abutments using two different resin cements. Forty multi-unit abutment analogs were individually fixed with chemically cured acrylic resin inside PVC cylinders using a parallelometer. Brass cylindrical abutments were tightened to the multi-unit abutments to be used as spacers and then castable UCLA abutments were positioned above. These abutments were cast with Ni-Cr and then divided into 4 groups (n=10): cemented with RelyX U100(r); cemented with RelyX U100(r) and simulation of acrylic resin polymerization process; cemented with Multilink(r); and cemented with Multilink(r) and simulation of acrylic resin polymerization process. Abutments were cemented according to manufacturers' instructions. In a universal testing machine, tensile strength was applied in the direction of the long axis of the abutments at 1 mm/min crosshead speed until displacement of the luted abutments was obtained. The values of maximum tensile force (N) required for the displacement of the luted abutments were tabulated and analyzed statistically by one-way ANOVA with a 95% confidence level. No statistically significant difference was found among the groups (p>0.05). There was an increase in mean tension force when the specimens were subjected to the simulation of acrylic resin polymerization process, but the results did not differ statistically. Both resin cements presented positive results as regards the retention of luted abutments on their respective multi-unit abutments. Both materials may be indicated for the technique of framework cemented on prepared abutments when professionals pursuit better adaptation of implant-supported frameworks.

Este estudo avaliou a força de tração de infraestruturas fundidas confeccionadas pela técnica da infraestrutura cimentada sobre pilares preparados utilizando dois diferentes cimentos resinosos. Quarenta análogos de pilares multi-unit foram individualmente fixados com resina acrílica quimicamente ativada em cilindros de PVC utilizando um delineador. Pilares cilíndricos foram torqueados aos pilares multi-unit para serem usados como espaçadores e, então, pilares calcináveis UCLA foram posicionados sobre eles. Estes pilares foram fundidos em liga de Ni-Cr e divididos em 4 grupos (n=10): cimentados com RelyX U100(r); cimentados com RelyX U100(r) e simulação do processo de polimerização da resina acrílica; cimentados com Multilink(r); e cimentados com Multilink(r) e simulação do processo de polimerização da resina acrílica. Os pilares foram cimentados de acordo com as recomendações dos fabricantes. Em máquina universal de ensaio, a resistência à tração foi aplicada na direção do longo eixo dos pilares a uma velocidade de 1 mm/min até o deslocamento do pilar cimentado ser obtido. Os valores da tração máxima (N) necessária para o deslocamento dos pilares cimentados foram tabulados e analisados estatisticamente pela ANOVA de 1 fator com 95% de nível de confiança. Diferença estatisticamente significativa não foi encontrada entre os grupos (p>0,05). Houve um aumento na força média de tração quando os espécimes foram submetidos à simulação de processo de polimerização da resina acrílica, mas os resultados não diferiram estatisticamente. Ambos os cimentos resinosos apresentaram resultados positivos no que diz respeito à retenção dos pilares cimentados em seus respectivos pilares multi-unit. Ambos os materiais podem ser indicados para a técnica da infraestrutura cimentada sobre pilares preparados quando os profissionais buscam melhor adaptação de infraestruturas de próteses implanto-suportadas.

Effect of pre-treatment with chlorhexidine on the retention of restorations: a randomized controlled trial.

This study aimed to evaluate the effect of chlorhexidine (CHX) application on etched dentin on the 6-month retention of restorations placed on non-carious cervical lesions (NCCLs). A randomized controlled split-mouth and triple blind trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. NCCLs were randomly assigned to two groups: control (placebo solution) or test group (2% CHX solution for 60 s after acid etching and before the adhesive application). Class V restorations (n=169) were performed with an etch-and-rinse adhesive system and composite resin by 10 trained operators. A calibrated examiner evaluated the restorations at 1 week (baseline) and at 6 months using the FDI criteria. The primary outcome was retention of the restorations. The analysis of factors associated to failure of restorations was carried out by Fisher's exact test (α=0.05). After 6 months of follow-up, 3.4% (CI 95% 1.3-7.3) of the restorations failed. There was no statistically significant difference between control and CHX (p=0.920). Regarding the cavity variables, deeper (p=0.04), wider (p=0.004) and wedge-shaped (p=0.033) cavities failed more. Both treatments provided acceptable clinical performance of the restorations. The use of CHX as a adjuvant in dentin adhesion did not influence the retention of Class V restorations after 6 months of follow-up.

Effect of Pre-treatment with Chlorhexidine on the Retention of Restorations: A Randomized Controlled Trial

This study aimed to evaluate the effect of chlorhexidine (CHX) application on etched dentin on the 6-month retention of restorations placed on non-carious cervical lesions (NCCLs). A randomized controlled split-mouth and triple blind trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. NCCLs were randomly assigned to two groups: control (placebo solution) or test group (2% CHX solution for 60 s after acid etching and before the adhesive application). Class V restorations (n=169) were performed with an etch-and-rinse adhesive system and composite resin by 10 trained operators. A calibrated examiner evaluated the restorations at 1 week (baseline) and at 6 months using the FDI criteria. The primary outcome was retention of the restorations. The analysis of factors associated to failure of restorations was carried out by Fisher's exact test (α=0.05). After 6 months of follow-up, 3.4% (CI 95% 1.3-7.3) of the restorations failed. There was no statistically significant difference between control and CHX (p=0.920). Regarding the cavity variables, deeper (p=0.04), wider (p=0.004) and wedge-shaped (p=0.033) cavities failed more. Both treatments provided acceptable clinical performance of the restorations. The use of CHX as a adjuvant in dentin adhesion did not influence the retention of Class V restorations after 6 months of follow-up.

O objetivo deste estudo foi avaliar o efeito da aplicação de clorexidina (CRX) em dentina condicionada na retenção de restaurações confeccionadas em lesões cervicais não-cariosas (LCNC) após 6 meses. Ensaio clínico randomizado triplo cego do tipo boca dividida foi conduzido. Pacientes (n=42) com no mínimo duas LCNC foram incluídos. LCNC foram randomizadas em dois grupos: controle (solução placebo) ou grupo teste (aplicação de CRX 2% por 60 s após o condicionamento e antes da aplicação do adesivo). Restaurações Classe V (n=169) foram realizadas com adesivo de condicionamento ácido total e resina composta, por 10 operadores treinados. Um examinador calibrado avaliou as restaurações após 1 semana (base) e 6 meses usando os critérios da FDI. O desfecho primário foi retenção das restaurações. A análise dos fatores associados à falha das restaurações foi conduzida com Teste Exato de Fisher (α=0,05). Após 6 meses de acompanhamento, 3,4% (IC 95% 1,3-7,3) das restaurações falharam. Não houve diferença estatística entre os grupos CRX e controle (p=0,920). Com relação às variáveis das cavidades, cavidades mais profundas (p=0,024), largas (p=0,004) e em formato de cunha (p=0,033) falharam mais. Ambos os tratamentos (CRX e controle) proporcionaram performance clínica aceitável das restaurações. O uso de CRX como coadjuvante na adesão à dentina não influenciou a retenção das restaurações Classe V após 6 meses de acompanhamento. .