Microtensile bond strength of etch-and-rinse and self-etch adhesives to artificially created carious dentin.

This article evaluates a pH-cycling model for simulation of caries-affected and caries-infected dentin (CAD and CID, respectively) surfaces, by comparing the bond strength of an etch-and-rinse and a self-etch adhesive system. For both adhesives, bonding to sound dentin (SD) showed that the microtensile bond strength (µTBS) values of SD, CAD, and CID were SD > CAD > CID (P < 0.05). Knoop microhardness number mean values followed the same trend. Adhesive systems were not able to totally penetrate into CAD and CID, forming more irregular resin-dentin interdiffusion zones and atypical resin tags than SD. The tested in vitro pH-cycling caries model allowed the evaluation of specific dentin substrate alterations in response to µTBS. The type of dentin and its histological structure played an important role in etch-and-rinse and self-etch bonding, as lower µTBS values were attained in CAD and CID.

Evaluation of bond strength and thickness of adhesive layer according to the techniques of applying adhesives in composite resin restorations.

Adhesive restorations have increasingly been used in dentistry, and the adhesive system application technique may determine the success of the restorative procedure. The aim of this study was to evaluate the influence of the application technique of two adhesive systems (Clearfil SE Bond and Adper Scotchbond MultiPurpose) on the bond strength and adhesive layer of composite resin restorations. Eight human third molars were selected and prepared with Class I occlusal cavities. The teeth were restored with composite using various application techniques for both adhesives, according to the following groups (n = 10): group 1 (control), systems were applied and adhesive was immediately light activated for 20 seconds without removing excesses; group 2, excess adhesive was removed with a gentle jet of air for 5 seconds; group 3, excess was removed with a dry microbrushtype device; and group 4, a gentle jet of air was applied after the microbrush and then light activation was performed. After this, the teeth were submitted to microtensile testing. For the two systems tested, no statistical differences were observed between groups 1 and 2. Groups 3 and 4 presented higher bond strength values compared with the other studied groups, allowing the conclusion that excess adhesive removal with a dry microbrush could improve bond strength in composite restorations. Predominance of adhesive fracture and thicker adhesive layer were observed via scanning electron microscopy (SEM) in groups 1 and 2. For groups 3 and 4, a mixed failure pattern and thinner adhesive layer were verified. Clinicians should be aware that excess adhesive may negatively affect bond strength, whereas a thin, uniform adhesive layer appears to be favorable.

Abordagens utilizadas na avaliação do risco de cárie / Approaches used in the assessment of caries risk

Objetivo: O objetivo do presente estudo foi conduzir uma revisão de literatura para discutir a atividade de cárie, bem como os fatores, indicadores e preditores de risco a ela relacionados, os quais foram pontualmente abordados. Revisão de literatura: Nesta revisão discutem-se os principais instrumentos considerados na determinação do risco, os quais incluem a verificação da experiência e da atividade de cárie, a condução de testes salivares, a análise de hábitos dietéticos e das condições de higiene bucal e a consideração de aspec-tos socioeconômicos. Considerações finais: Com base nas evidências disponíveis conclui-se que: 1) quando analisados isoladamente, os fatores, indicadores e preditores de risco podem fornecem subsídios limitados à determinação do risco de cárie; 2) a experiência passada e a atividade de lesões incipientes são os melhores preditores do risco de cárie; 3) dentre os aspectos salivares, o fluxo caracteriza-se como o principal componente na predição do risco; 4) quando o biofilme é desorganizado e o indivíduo tem acesso a fontes de fluoreto, o consumo de sacarose parece ter um papel secundário no risco da doença; 5) aspectos socioeconômicos podem ter influência no risco de cárie.

Avaliação in vitro das alterações verificadas em canais radiculares artificiais curvos preparados por dois sistemas rotatórios / In vitro evaluation of shape changes in curved artificial root canals prepared with two rotary systems

O objetivo desta pesquisa experimental in vitro foi analisar comparativamente as deformações no canal radicular apóso uso do sistema rotatório de NiTi ProTaper Universal, ProDesign e técnicas híbridas utilizando os dois sistemas. Foram utilizados e instrumentados, setenta e cinco blocos com canais radiculares artificiais, divididos em cinco grupos(n=15). Para o grupo 1, os preparos foram realizados pelo sistema ProTaper Universal, utilizando a lima F3 no preparo apical. Para o grupo 2, utilizou-se o sistema ProDesign com preparo apical usando a lima 30/0,2. Para o grupo 3,os preparos foram realizados pelo sistema ProTaper Universal,utilizando a lima F2 no preparo apical. Para o grupo 4, os sistemas ProDesign e ProTaper foram utilizado sem conjunto com preparo realizado com a lima F2. Para o grupo 5, os sistemas ProDesign e ProTaper foram utilizados em conjunto com preparo apical realizado com as limas F1 e F2. As brocas de Gates-Glidden #5, #4, #3, #2 e#1 realizaram o preparo da porção reta de todos os canais,caracterizando o preparo cervicoapical. Foram analisados a diferença e o quociente da quantidade de resina removida nos seis milímetros de curvatura, aferidos tanto na parte interna quanto na parte externa. Zip e elbow foram quantificados pela forma final, após instrumentação em cada grupo testado. Para análise dos dados utilizou-se os testes paramétricos (ANOVA p<0,05), não paramétrico Kruskal--Wallis (p<0,05) e qui-quadrado (p<0,05). Para diferença e quociente, verificou-se melhores formas para os grupos 2 e3. Através da análise quantitativa e qualitativa, observou-se melhores preparos com o sistema ProDesign e ProTaperUniversal com preparo apical utilizando lima F2.

The aim of this in vitro experimental analysis was to comparethe changes in canal shape after the use of ProTaper UniversalNiTi rotary system, ProDesign system, and a hybridtechnique using both systems. A total of seventy-five simulatedroot canals were prepared and divided into five groups(n = 15). For Group 1, the ProTaper Universal System withapical preparation file F3 was used. For Group 2, ProDesignSystem with apical preparation using file 30/0.2 was used.For Group 3, ProTaper Universal System with apical preparationwith file F2 was applied. For Group 4, ProDesign Systemand ProTaper Universal System with apical preparationwith file F2 were applied. For Group 5, ProDesign Systemand ProTaper Universal System with apical preparation F1and F2 were used. All instrumentation was performed withthe help of Gates-Glidden drills #5, #4, #3, #2 and #1 accordingto crow-down preparation. The difference and thequotient the amount of removed resin were analyzed withinsix millimeters of the canal curvature, measured for both innerand outer walls. The amount of zip and elbow apical formationand mean final shape for each type tested were analyzed.Data were analyzed using parametric tests (ANOVA p<0.05),non-parametric test Kruskal-Wallis (p<0.05) and Chi-squaretest (p<0.05). When difference, quotient and final mean shapewere analyzed, the best preparations were observed in groups2 and 3. Through qualitative and quantitative analysis, thebest preparations were obtained with ProDesign System andProTaper Universal System with apical preparation file F2.

Dual resin cement knoop hardness after different activation modes through dental ceramics.

This study investigated the influence of ceramic compositions on Knoop Hardness Number (KHN) immediately and 24 h after polymerization and the effect of activation modes on the KHN of a resin cement. Ten Panavia F 2.0 resin cement discs were activated either directly using curing light, or chemically without light, or through 1.2-thick ceramic discs. The following ceramics were evaluated: Duceram, Cergogold, IPS Empress, IPS Empress 2, Procera, Cercon, In Ceram Alumina and In Ceram Zirconia. The KHN was obtained immediately and after 24-h testing time. Two-way ANOVA and Tukey's test were performed for statistical analysis (p<0.05). Direct activation showed higher KHN than activation through ceramics and chemical activation for both immediate and 24-h post activation. The KHN for 24-h post activation time was higher than that of the immediate post activation time except for the direct activation mode. The glass and di-silicate based ceramics showed higher KHN than alumina- and zirconia-based ceramics, immediately and after 24-h. The reinforced and opaque ceramics had the lowest KHN. The ceramic composition resulted in light attenuation, lower polymerization and lower KHN, and the 24-h testing time promoted an improvement of KHN except for direct activation mode.

Dual resin cement knoop hardness after different activation modes through dental ceramics

This study investigated the influence of ceramic compositions on Knoop Hardness Number (KHN) immediately and 24 h after polymerization and the effect of activation modes on the KHN of a resin cement. Ten Panavia F 2.0 resin cement discs were activated either directly using curing light, or chemically without light, or through 1.2-thick ceramic discs. The following ceramics were evaluated: Duceram, Cergogold, IPS Empress, IPS Empress 2, Procera, Cercon, In Ceram Alumina and In Ceram Zirconia. The KHN was obtained immediately and after 24-h testing time. Two-way ANOVA and Tukey's test were performed for statistical analysis (p<0.05). Direct activation showed higher KHN than activation through ceramics and chemical activation for both immediate and 24-h post activation. The KHN for 24-h post activation time was higher than that of the immediate post activation time except for the direct activation mode. The glass and di-silicate based ceramics showed higher KHN than alumina- and zirconia-based ceramics, immediately and after 24-h. The reinforced and opaque ceramics had the lowest KHN. The ceramic composition resulted in light attenuation, lower polymerization and lower KHN, and the 24-h testing time promoted an improvement of KHN except for direct activation mode.

Este estudo investigou a influência de composições de cerâmica no número de dureza Knoop (KHN), imediatamente e 24 h após a polimerização; e o efeito de modos de ativação na KHN de um cimento resinoso. Dez discos de cimento resinoso Panavia F 2.0 foram ativados diretamente usando uma fonte de luz, ou quimicamente sem luz, ou através de discos de cerâmica com espessura de 1,2 mm. As cerâmicas avaliadas foram Duceram, Cergogold, IPS Empress, IPS Empress 2, Procera, Cercon, In Ceram Alumina e In Ceram Zirconia. O KHN foi obtido nos tempos imediatamente e após 24 h. Os testes ANOVA two-way e Tukey foram realizados para a análise estatística (p<0,05). A ativação direta apresentou maiores KHN que a ativação através das cerâmicas e ativação química, para ambos os tempos testados imediatamente e após 24 h. O KHN para o tempo de ativação testado após 24 h foi superior que o tempo imediatamente, exceto para o modo de ativação direto. As cerâmicas à base de vidro e di-silicato apresentaram KHN superiores que as cerâmicas à base de alumina e zircônia, imediatamente e após 24 h. As cerâmicas mais reforçadas e opacas resultaram um dos menores KHN. A composição da cerâmica resulta em atenuação de luz, menor polimerização e menor KHN; e o tempo de 24 h testado promove uma melhora no KHN, exceto para o modo de ativação direto.

Effect of surface treatment and storage on the bond strength of different ceramic systems

Aim: The aim of this study was to evaluate the micro shear bond strength of different ceramic systems – IPS Empress 2, Cergogold, In-Ceram Alumina and Cercon - and a dual luting agent. Methods: Twelve specimens of each ceramic were fabricated and divided according different surface treatments: Group 1: No additional treatment was applied to the ceramic surface; Group 2: Ceramics were etched with 9.5% hydrofluoric acid; Group 3: specimens treated with airborne particle abrasion for each ceramic system in accordance with manufacturer’s instructions (n=20). The tests were performed after 24 h or after water storage for 6 months. Data were then assessed statistically using the 3-way ANOVA and the Tukey’s test (P<0.05). Results: For Cergogold and IPS Empress 2 systems, the treatments performed with airborne particle abrasion and hydrofluoric acid showed no significant differences from each other, and both were superior to the groups without treatment. For Cercon and In-Ceram ceramics, no differences were found among the groups (P<0.05). When the surface was treated with hydrofluoric acid, the highest bond strength was found to IPS Empress 2 in the 6-month storage period (P<0.05). Conclusion: Lower bond strength values were only observed with IPS Empress 2 ceramic for the control group in the 6-month storage (P<0.05).

O condicionamento ácido prévio ainda é indispensável para a odontologia adesiva? / Is previous total etching still indispensable for the adhesive dentistry?

O objetivo deste trabalho foi avaliar as características dos sistemas adesivos disponíveis atualmente considerando a aplicação ou não do condicionamento prévio com ácido fosfórico. O conhecimento das estruturas e o tratamento adequado do substrato dental são fundamentais para utilização dos adesivos convencionais. Os sistemas adesivos autocondicionantes possuem técnica simplificada dispensando o condicionamento ácido prévio. O profissional deverá ter conhecimento dos mecanismos de adesão ao substrato dental, experiência clínica e domínio da técnica de aplicação do adesivo escolhido. O condicionamento ácido prévio não deve ser considerado indispensável na Odontologia adesiva atual.

Influence of different exposure time required to stabilize hardness values of composite resin restorations.

AIM: The purpose of this study was to evaluate if Knoop hardness values (KHN) for top and bottom surfaces of resin composite materials can reach a plateau within a clinically acceptable photoactivation time. METHODS AND MATERIALS: Four light-curing units (LCUs) were evaluated in this study (n=5): QTH (Optilux501: 550 mW/cm2) and LEDs (FreeLight2: 1100 mW/cm2; UltraLume5: 900 mW/cm2; and Radii: 750 mW/cm2). Composite resin discs (4 mm x 2 mm) of Heliomolar (Ivoclar/Vivadent) and Herculite XRV (Kerr) were tested using five photoactivation times (20, 40, 60, 80, and 100 seconds). KHN were obtained for each test specimen and comparisons between LCUs, depths, and photoactivation times were analyzed using two-way analysis of variance (ANOVA) and polynomial regression analysis. RESULTS: Data for Heliomolar discs using linear regression found a relationship between the independent variables KHN and time with the Optilux501 at the top and bottom surfaces (r2=0.68/ r2=0.66). Radii presented a linear regression at the top surface (r2=0.75) and a quadratic regression at the bottom (r2=0.94). A quadratic regression was also detected for UltraLume5 and FreeLight2 at both top (r2=0.84/ r2=0.94) and bottom surfaces (r2=0.97/ r2=0.90), respectively, reaching a plateau at 80 seconds in all cases. For Herculite XRV, a quadratic regression was observed for all LCUs at the top and bottom surfaces and 80 seconds irradiation time was needed to reach a plateau in KHN. CONCLUSION: There is a specific, but not clinically acceptable, photoactivation time that KHN at both top and bottom surfaces can reach a plateau and is dependent on LCUs and the resin-composite tested. CLINICAL SIGNIFICANCE: The LCUs and the resin-composite formulation affected the exposure time required to stabilize hardness values. The overall performance of LED LCUs was better than the QTH LCU regardless of the material evaluated.

Influence of different ceramics on resin cement Knoop Hardness Number.

This study evaluated: (1) the effect of different ceramics on light attenuation that could affect microhardness, measured as the Knoop Hardness Number (KHN), of a resin cement immediately and 24 hours after polymerization and (2) the effect of different activation modes (direct light-activation, light activation through ceramics and chemical activation) on the KHN of a resin cement. Resin cement Rely XARC (3M ESPE) specimens 5.0 mm in diameter and 1.0 mm thickwere made in a Teflon mold covered with a polyester film. The cement was directly light activated for 40 seconds with an XL 2500 curing unit (3M ESPE) with 650 mW/cm2, light activated through ceramic discs of Duceram Plus (DeguDent), Cergogold (DeguDent), IPS Empress (Ivoclar), IPS Empress 2 (Ivoclar), Procera (NobelBiocare), In Ceram Alumina (Vita) and Cercon (DeguDent), having a 1.2 mm thickness or chemically activatedwith-out light application. The resin cement specimens were flattened, and KHN wasobtained using an HMV 2 microhardnesstester (Shimadzu) with a load of 50 g applied for 15 seconds 100 microm from the irradiated surface immediately and after storage at 37 degrees C for 24 hours. Ten measurements were made for each specimen, with three specimens for each group at each time. The data were submitted to ANOVA and Tukey's test (p = 0.05). The KHN of the resin cement was not only affected by the mode of activation, but also by the post-activation testing time. The mean KHN of the resin cementfor chemical activation and through all ceramics showed statistically significant lower values compared to direct activation immediately and at 24 hours. The KHN for 24 hourspost-activation was always superior to the immediate post-activation test except with direct activation. The most opaque ceramics resulted in the lowest KHN values.

Effect of the flask contention method on the displacement of maxillary denture teeth

Keeping the flask closed may reduce the stress released by the resin dough after the pressing step, preserving the tooth relationship pattern. The aim of this study was to analyze the influence of the flask contention method on tooth displacement in acrylic resin complete dentures. Twenty identical maxillary complete dentures were made using the heat-cured acrylic resins Classico and QC-20, polymerized by long and fast polymerization cycles respectively, and randomly assigned to 4 test groups according to the conventional packing method and RS tension system. Transversal and anteroposterior distances between specific teeth were measured with a linear optical microscope before and after denture processing. Analysis of variance (ANOVA) and Tukey test were used to compare the groups (p<.05). Results showed that tooth movement was significantly greater for the distance RI-LI in comparison with the others, and the tooth movement was not significantly influenced by the packing method. Within the limitations of this study, the RS tension system presented a similar performance in reducing the tooth movement, when compared with the conventional packing method. The anterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted.

In vitro microTBS of one-bottle adhesive systems: sound versus artificially-created caries-affected dentin.

This in vitro study aimed to evaluate a pH-cycling model for simulation of caries-affected dentin (CAD) surfaces, by comparing the bond strength of etch-and-rinse adhesive systems on sound and artificially-created CAD. Dentin substrates with different mineral contents and morphological patterns were created by submitting buccal bovine dentin to the following treatments: (1) immersion in artificial saliva during the experimental period (sound dentin, SD), or (2) induction to a CAD condition by means of a dynamic pH-cycling model (8 cycles, demineralization for 3 h followed by mineralization for 45 h). The bond strength of Excite or Prime and Bond NT adhesive systems was assessed using the microtensile bond strength (microTBS) test. Dentin microhardness was determined by cross-sectional Knoop evaluations. Resin-dentin morphology after the treatments was examined by scanning electron microscopy. SD produced significantly higher microTBS than CAD for both adhesives evaluated, without differences between materials. CAD exhibited lower microhardness than SD. Morphological analysis showed marked distinctions between SD and CAD bonded interfaces. Under the conditions of this study, differences in morphological pattern and dentin mineral content may help to explain resin-dentin bond strengths. The proposed pH-cycling model may be a suitable method to simulate CAD surfaces for bonding evaluations.

Esthetic analysis of the smile

This study analyzed the esthetics components of the smile, evaluating the relationship between the curve formed by the incisal line of the anterior superior teeth and the curve of the inferior lip, the touch of this incisal line on the inferior lip, the teeth displayed during smile, the relationship between the facial midline with the arch midline, the location of the arch midline and gender differences. Eighty-eight undergraduate students of the dentistry course of the TiradentesUniversity were selected. Two photographs were taken (smiling face and smile) using digital camera. The statistical analysis was performed after image tracing evaluation. Results show that the coincidence of the facial midline with the arch midline occurred only on half of the students. Most of the students presented parallelism between the incisal plan and the interpupillary line. Smiles with or without touch of the incisal line on the lower lip, smiles revealing up to the seconds premolars or firsts molars, and parallel or straight smiles were also most commonly observed. The majority of the men presented centeredmidline arch while women presented deviation to the right. No difference was found between the distribution of the arch midline.

Effect of 10% carbamide peroxide dental bleaching on microhardness of filled and unfilled sealant materials.

PURPOSE: The purpose of this study was to quantitatively evaluate the effect of 10% carbamide peroxide on the microhardness of pit and fissure sealant materials. METHODS: Fluroshield, Vitroseal Alfa, and one unfilled (Clinpro) sealants were placed in Teflon matrices (4 mm in diameter by 2 mm in height) and polymerized for 40 seconds. A total of 20 specimens were prepared for each material, in which half were assigned as the control group (stored in artificial saliva and no bleaching treatment). For the remaining half, Clarigel Gold bleaching agent (10% carbamide peroxide) was placed over the specimen surface for 4 hours/day during 4 weeks. When specimens were not under bleaching treatment, they were kept in artificial saliva. Afterwards, specimens were subjected to Knoop microhardness testing using a 25-g load for 5 seconds. Five measurements were made on the sealants' surfaces and then calculated in Knoop hardness values. The data were statistically analyzed by two-way analysis of variance and Tukey's tests with a 5% confidence level. RESULTS: The results of this in vitro study showed that the application of a carbamide peroxide-based bleaching material significantly affected the microhardness values of filled sealant materials. The bleaching agent did not affect the microhardness of the unfilled sealant. CLINICAL SIGNIFICANCE The results of this in vitro study suggest that the bleaching agents altered the surface hardness of filled sealant restorative materials. This could possibly lead to increased wear and surface roughness.

Hybrid layer thickness and resin tag length of a self-etching adhesive bonded to sound dentin.

OBJECTIVES: the purpose of this study is to employ optical microscopy to measure the thickness of the hybrid layer and the penetration (tags) of an aggressive self-etching adhesive system into sound dentin. METHODS: occlusal cavities were prepared in 40 extracted human posterior teeth. The prepared teeth were randomly assigned to four experimental groups with 10 specimens each. The self-etching adhesive system Adper Prompt L-Pop was applied to the dentin surface as follows: Group 1: cavosurface enamel was etched for 60 s and dentin for 20 s with 35% phosphoric acid gel, immediately followed by application of the self-etching adhesive with a brush to the entire cavity for 15 s; Groups 2, 3, and 4: no pre-etching was performed, and the self-etching adhesive was applied to both enamel and dentin for 15, 30 and 45 s, respectively. After curing, the cavities were filled with composite resin Filtek Z250. Afterwards, the teeth were decalcified and the restorations were carefully removed for later embedding in paraffin. The specimens were serially sectioned at 6 microm of thickness and sequentially mounted in glass slides. These sections were stained with Brown and Brenn staining for posterior analysis and measurement of the hybrid layer and resin tags on a light microscope with a micrometric ocular 40/075. The results were submitted to analysis of variance at the 5% level. RESULTS: whenever there was significance, the Tukey test was applied at the 5% level. The specimens receiving application of acid etching before the self-etching adhesive displayed a larger thickness of the hybrid layer; on the other hand, specimens receiving only application of the self-etching adhesive on dentin for 15, 30 and 45 s exhibited similar thickness of the hybrid layer. As regards the resin tags, no statistically significant differences could be found between the study groups. CONCLUSIONS: it could be concluded that the increase in the time of application of the self-etching adhesive Adper Prompt L-Pop did not significantly influence the formation and thickness of hybrid layer, as well as its penetration into the sound dentin surface.