Fatigue survival of endodontically treated teeth restored with different fiber-reinforced composite resin post strategies versus universal 2-piece fiber post system: An in vitro study.

STATEMENT OF PROBLEM: Various strategies have been proposed to reduce the cement space of foundation restorations for endodontically treated teeth. However, they may add more operative steps, or the dentist must keep different sizes of drills and posts in stock. A 2-piece universal adjustable post system has been developed to overcome this problem, but whether the system has acceptable fatigue survival performance is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the fatigue survival and stress distribution of endodontically treated teeth without a ferrule and restored with different glass fiber post strategies versus a recently introduced universal 2-piece fiber post system. MATERIAL AND METHODS: Bovine incisor roots were randomly assigned to 3 groups as per the post used (n=13): adapted glass fiber post with post space preparation of the same size, composite resin-custom glass fiber post (CTM), and universal 2-piece glass fiber-reinforced composite resin post (UNI). The posts were adhesively luted, the composite resin core was added, and a composite resin crown was produced with computer-aided design and computer-aided manufacturing (CAD-CAM), and then adhesively luted to each core. A fatigue test was performed with the stepwise stress method (10 000 cycles/step; 20 Hz; load=100 N to 750 N; step=50 N) until fracture, and the failure mode analyzed. The stress distribution was evaluated by finite element analysis with the maximum principal stress criteria by following the parameters of the in vitro test. The solids were considered homogeneous, linear, and isotropic, except for the glass fiber post (orthotropic), and a load of 450 N at 30 degrees was applied. The fatigue failure load and the number of cycles for failure were analyzed with Kaplan-Meier and Mantel-Cox (log rank test) (α=.05). The finite element analysis results were analyzed with colorimetric graphs. RESULTS: The highest fatigue failure load and the number of cycles for failure were found in the UNI system, whereas the lowest results were found in the CTM group. All groups exhibited repairable failures. The finite element analysis showed the lowest stress in root dentin in the UNI system. The CTM system had the largest stress regions at the dentin and dentin-core interface. CONCLUSIONS: The use of a 2-piece universal glass fiber post system resulted in more fatigue behavior compared with composite resin-custom glass fiber posts.

Removable partial dentures: use of rapid prototyping.

The CAD/CAM technology associated with rapid prototyping (RP) is already widely used in the fabrication of all-ceramic fixed prostheses and in the biomedical area; however, the use of this technology for the manufacture of metal frames for removable dentures is new. This work reports the results of a literature review conducted on the use of CAD/CAM and RP in the manufacture of removable partial dentures.

Influence of vitamin D on muscle strength and botulinum toxin dosage through surface electromyography.

PURPOSE: To evaluate the influence of patients' serum vitamin D levels on muscle strength characteristics and whether it impacts the durability of botulinum toxin (BT) treatment. METHODS: The muscle strength of the frontal and corrugator muscles was evaluated before and after the application of TB with pre- and post-application control measurements, and at weeks 2, 5 and 12. The effect of vitamin D on muscle strength and its interaction with BT were investigated in 20 patients. The muscle contraction force was measured by surface electromyography. RESULTS: The results revealed statistically significant differences between the frontal measurement groups at weeks 2 and 5, as well as for the corrugator in the same weeks and at week 12. Regarding vitamin D, significant differences were observed only in the initial group with vitamin D > 30 ng/mL compared to < 30 ng/mL for the frontal muscles. Patients with higher levels of vitamin D had higher average muscle strength compared to those with lower levels in all evaluations. CONCLUSIONS: It was observed that vitamin D influences muscle strength and the necessary dosage of BT.

In Vitro Comparison of Microleakage, Marginal Fit, and Cement Thickness of Conventional and Prepless Lithium Disilicate Veneers

PURPOSE: To assess the influence of two preparation techniques on the microleakage, marginal fit, and cement thickness of lithium disilicate veneers. MATERIALS AND METHODS: A total of 24 human maxillary central incisors were divided randomly into two groups according to preparation technique (n = 12): minimally invasive preparation with butt-joint design (0.3-mm depth) and a chamfer finish line (group MP); and no preparation (NP). All teeth were restored with lithium disilicate veneers cemented with photopolymerizable resin cement. Specimens were aged thermally (6,000 cycles of 5°C to 55°C) and mechanically (100,000 cycles at 100 N, 4 Hz). Specimens were immersed in fuchsin for 24 hours employing a standard dye penetration technique, then sectioned and evaluated under a stereomicroscope (x20). Data were analyzed by ANOVA and Kruskal-Wallis tests (P < .05). RESULTS: There was significant microleakage (P = .0163) at the cervical area compared to the proximal area. The marginal fit was similar, with no statistical difference (P = .212) between groups MP (153 ± 81 µm) and NP (111 ± 74 µm). Group MP showed a significantly (P = .006) reduced cement thickness at the cervical area (87 ± 27 µm) compared to group NP (210 ± 89 µm). CONCLUSION: Although the preparation technique was shown to influence the cement thickness, it did not show any influence on microleakage or marginal fit.

Effect of different materials and undercut on the removal force and stress distribution in circumferential clasps during direct retainer action in removable partial dentures.

OBJECTIVES: This study aimed to evaluate the effect of different materials and undercut on the removal force and stress distribution in the supporting tooth and in the circumferential clasp used in removable partial prosthesis. METHODS: Upper molars prepared for Akers circumferential clasp with retention and opposing arm were modeled, scanned, elaborated with CAD software and the geometries imported in FEA and analyzed. Six different materials were selected for the clasp (Polyamide, Polyoxymethylene, Polyetheretherketone - PEEK, Gold alloy, Titanium and CoCr) and 3 different undercuts (0.25, 0.50 and 0.75mm), totaling 18 groups. RESULTS: The clasps presented greater stress in their structure and potentially greater damage to the dental enamel when made with rigid materials and with more undercut; however, they presented greater ability to remain in position. SIGNIFICANCE: Polyamide with a higher undercut is an esthetic alternative to rigid metallic clasps. It showed promising behavior because it strongly reduces the damage to the enamel, and even with an undercut of 0.75, the retention is lower than for CoCr with a 0.25 undercut, and this retention might still be sufficient. Polyoxymethylene and Polyetheretherketone (PEEK) are not suitable materials for the clasps, because the maximum stress occurring during removal with higher undercuts is higher than the material strength.

Mechanical behavior of implant assisted removable partial denture for Kennedy class II.

BACKGROUND: This study evaluated the mechanical response of a removable partial denture (RPD) in Kennedy Class II according to being associated or not with implants. MATERIAL AND METHODS: Four RPDs were manufactured for a Kennedy Class II: CRPD - Conventional RPD, RPD+1M, RPD+2M and RPD+12M, respectively, signifying implant assisted RPDs with the implant installed in the first molar, second molar, and in the first and second molars. The finite element method was used to determine the most damaged support tooth under compressive load (300N, 10s) and strain gauge analysis was used to evaluate the microstrain. All groups were submitted to a retentive force analysis (0.5 mm/mm, 100kgf). Microstrain and retentive force data were submitted to One-way ANOVA and the Tukey test, all with α=5%. RESULTS: High microstrain was observed in the second premolar adjacent to the edentulous space under compression load (p< 0.01). RPD+12M presented lower microstrain, however being similar to RPD+2M. RPD+1M presented a higher mean value of retentive force, but similar to RPD+12M. FEM showed RPD assisted by implants concentrates less stress in the periodontal ligament. The association of two implants was sufficient to decrease the stress generated in the implants. The most stressed region for the o-ring abutment was the threads, and the group with two implants showed the lowest stress concentration. CONCLUSIONS: In cases of Kennedy Class II, the association of RPD with implants in the molar region is a favorable option for patient rehabilitation, reducing the movement of the direct retainer adjacent to the edentulous space, increasing the removal force and decreasing the stress magnitude in the periodontal ligament. Key words:Removable partial denture, Finite element analysis, Prosthetic dentistry, Implant-assisted RPD, Distal extension RPD considerations.

Dimensional accuracy of provisional complete crown made by the 3D printing method / Acuidade dimensional de coroas totais provisórias confeccionadas pelo método de impressão 3D

Objective: This study evaluated the dimensional accuracy of provisional complete crowns printed with photopolymerizable resin using an LCD-type 3D printer through optical metrology, varying the printing angle and the number of complete crowns printed at once on a single-build platform. Material and Methods: The complete crowns were printed with temporary crown resin, A2 temporary (Wilcos do Brasil), divided into four groups with n=12: Group A - 3 complete crowns positioned at 150° on the x-axis; Group B - 4 complete crowns positioned at 150° on the x-axis; Group C - 3 complete crowns positioned at 180° on the x-axis; and Group D - 4 complete crowns positioned at 180° on the x-axis. Dimensional accuracy was assessed by overlaying images in the Gom Inspect measurement software, where the STL of each complete crown was aligned and compared to the master model. For statistical analysis, one-way ANOVA and Shapiro-Wilk tests were used. Results: No significant statistical difference was observed between the differentangles, or the number of complete crowns printed at once. Conclusion: Based on dimensional accuracy, the printing of provisional complete crowns with an LCD-type 3D printer shows no significant statistical difference with either the 150 or 180-degree angle variations, and there is also no difference when printing 3 or 4 complete crowns at once.(AU)

Objetivo: Este estudo avaliou a acuidade dimensional de coroas totais provisórias impressas com resina fotopolimerizável por uma impressora 3D tipo LCD por meio da metrologia optica, variando angulação de impressão e número de coroas impressas por vez em uma única plataforma de construção. Material e Métodos: As coroas foram impressas com resina para coroa provisória, A2 temporário (Wilcos do Brasil), divididas em quatro grupos com n=12: Grupo A - 3 coroas posicionadas a 150° no eixo x; Grupo B - 4 coroas posicionadas a 150° no eixo x; Grupo C - 3 coroas posicionadas a 180° no eixo x e Grupo D - 4 coroas posicionadas a 180° no eixo x. A acuidade dimensional foi feita com a sobreposição de imagens no programa de aferição Gom Inspect, em que o STL de cada coroa foi alinhado e comparado ao modelo mestre. Para análise estatística, foram utilizados os testes ANOVA um fator e Shapiro-Wilk. Resultados: Não foi verificada diferença estatística significativa entre as diferentes angulações ou quantitadade de coroas impressas em uma única vez. Conclusão: Com base na acuidade dimensional, a impressão de coroas provisórias com impressora 3D tipo LCD não apresenta diferença estatística significative com nenhuma das duas variações angulação de 150 ou 180 graus e não há diferença também ao fazer a impressão de 3 ou 4 coroas de uma única vez.(AU)

Influence of vitamin D on muscle strength and botulinum toxin dosage through surface electromyography

Purpose: To evaluate the influence of patients' serum vitamin D levels on muscle strength characteristics and whether it impacts the durability of botulinum toxin (BT) treatment. Methods: The muscle strength of the frontal and corrugator muscles was evaluated before and after the application of TB with pre- and post-application control measurements, and at weeks 2, 5 and 12. The effect of vitamin D on muscle strength and its interaction with BT were investigated in 20 patients. The muscle contraction force was measured by surface electromyography. Results: The results revealed statistically significant differences between the frontal measurement groups at weeks 2 and 5, as well as for the corrugator in the same weeks and at week 12. Regarding vitamin D, significant differences were observed only in the initial group with vitamin D > 30 ng/mL compared to < 30 ng/mL for the frontal muscles. Patients with higher levels of vitamin D had higher average muscle strength compared to those with lower levels in all evaluations. Conclusions: It was observed that vitamin D influences muscle strength and the necessary dosage of BT.

Relato de caso clínico de preenchimento labial com ácido hialurônico e avaliações volumétricas através de software de análise facial 3d / Clinical case report of hyaluronic acid lip filler and volumetric evaluations using 3d facial analysis software / Reporte de caso clínico de relleno labial con ácido hialurónico y evaluaciones volumétricas utilizando software de análisis facial 3d

A análise facial consiste em uma etapa importante do diagnóstico e avaliação dos resultados obtidos na harmonização orofacial. Para avaliação dos resultados de procedimentos estéticos, fotografias são muito utilizadas, porém novas ferramentas são necessárias para facilitar a visualização dos pacientes quanto aos ganhos estéticos. Os scanners faciais 3D surgem como alternativa para tal finalidade. O objetivo deste estudo foi analisar, através de fotografias e escaneamento 3D da face, o ganho de volume labial após intervenção de preenchimento. A paciente apresentava insatisfação com relação aos seus lábios. Durante a avaliação, constatou-se ausência de volume e contorno labial. Antes de iniciar o procedimento, realizou-se protocolo fotográfico e escaneamento facial (E1). Para o procedimento, foi utilizada uma seringa de 1 mL de ácido hialurônico. O escaneamento foi feito no pós-imediato (E2), após 10 dias (E3) e após 40 dias da intervenção (E4). Nesta mesma consulta após 40 dias, foi realizado injeção da segunda seringa de ácido hialurônico escaneamento do pós-imediato (E5). Após 40 dias, a paciente voltou (E6). Após análise comparativa das malhas, foi possível verificar ganho de 3 mm entre E1 e E2. Na comparação do pré (E1) e após 10 dias (E3), verificou-se volumização total de 1,85 mm, demonstrando que quase 40% do volume no pós-imediato é edema. Em E6, após 40 dias da aplicação da segunda seringa, foi possível quantificar ganho de 2,12 mm no lábio superior quando comparado a E1. Pode-se concluir que o escaneamento 3D contribui expressivamente para avaliação dos resultados alcançados em procedimentos estéticos.

Facial analysis is an important stage in the diagnosis and evaluation of the results obtained in orofacial harmonization. To evaluate the results of aesthetic procedures, photographs are widely used, but new tools are needed to facilitate patient visualization of aesthetic gains. 3D facial scanners have emerged as an alternative for this purpose. The aim of this study was to analyze, by means of photographs and 3D facial scanning, the labial volume gain after a filling intervention. The patient was dissatisfied with her lips. During the evaluation, it was observed the absence of lip volume and contour. Before starting the procedure, a photographic protocol and facial scanning (S1) were performed. A 1 mL syringe of hyaluronic acid was used for the procedure. The scanning was done post-immediately (S2), 10 days (S3) and 40 days after the intervention (S4). In the same appointment after 40 days, the second syringe of hyaluronic acid was injected and scanned post-immediate (S5). After 40 days, the patient returned (E6). After comparative mesh analysis, it was possible to verify a 3 mm gain between S1 and S2. In the comparison of pre (S1) and after 10 days (S3), there was a total volumization of 1.85 mm, showing that almost 40% of the volume in the post-immediate period is edema. In S6, 40 days after the application of the second syringe, it was possible to quantify a gain of 2.12 mm in the upper lip when compared to S1. It can be concluded that 3D scanning contributes expressively to the evaluation of the results achieved in aesthetic procedures.

El análisis facial es una etapa importante en el diagnóstico y la evaluación de los resultados obtenidos en la armonización orofacial. Para evaluar los resultados de los procedimientos estéticos, las fotografías son ampliamente utilizadas, pero se necesitan nuevas herramientas que faciliten al paciente la visualización de las ganancias estéticas. Los escáneres faciales 3D han surgido como una alternativa para este fin. El objetivo de este estudio fue analizar, mediante fotografías y escaneado facial 3D, la ganancia de volumen labial tras una intervención de relleno. La paciente estaba insatisfecha con sus labios. Durante la evaluación, se observó la ausencia de volumen y contorno labial. Antes de iniciar el procedimiento, se realizó un protocolo fotográfico y un escaneado facial (S1). Para el procedimiento se utilizó una jeringa de 1 ml de ácido hialurónico. La exploración se realizó inmediatamente después (S2), a los 10 días (S3) y a los 40 días de la intervención (S4). En la misma consulta, a los 40 días, se realizó la inyección de la segunda jeringa de ácido hialurónico tras la exploración inmediata (S5). A los 40 días, la paciente regresó (E6). Tras el análisis comparativo de las mallas, se pudo comprobar una ganancia de 3 mm entre S1 y S2. En la comparación del pre (S1) y después de 10 días (S3), hubo una volumización total de 1,85 mm, demostrando que casi 40% del volumen post-immediato es edema. En S6, 40 días después de la aplicación de la segunda jeringa, fue posible cuantificar una ganancia de 2,12 mm en el labio superior en comparación con S1. Se puede concluir que el escaneo 3D contribuye expresivamente para la evaluación de los resultados alcanzados en procedimientos estéticos.

Stress distribution in lower second molar mesialization using mini-implants: a pilot study using 3D finite element analysis / Distribuição de tensões na mesialização do segundo molar inferior usando mini-implantes: um estudo piloto usando análise de elementos finitos 3D

Objective: to analyze the stress distribution in a 3D model that simulates second molar mesialization using two different types of mini-implants. Material and Methods: a mandible bone model was obtained by recomposing a computed tomography performed by a software program. The cortical and trabecular bone, a lower second molar, periodontal ligament, orthodontic tube, resin cement and the mini-implants were designed and modeled using the Rhinoceros 4.0 software program. The characteristics of self-drilling orthodontic mini-implants were: one with 7 mm length, 1 mm transmucosal neck section and 1.6 mm diameter and another with 5 mm length and 1.5 mm diameter. A total of 235.161 and 224.505 elements were used for the mesh. These models were inserted into the bone block and then subjected to loads of 200 cN (centinewton). The results were calculated and analyzed by the Ansys 17.0 software program for qualitative verification through displacement and maximum principal stress maps. Results: it was possible to observe that the periodontal ligament presented low displacement and stress values. However, the physiological values presented are among those capable to provide orthodontic movement, with compression and tensile area visualization staggered between 0.1 and -0.1 MPa (megapascal). Conclusion: within the limitations of the study, the mini-implants tested showed similar results where the load on the tooth allowed dental displacement (molar mesialization), with a tendency to rotate it, theoretically allowing the second molar to take the location of the first molar. (AU)

Objetivo: analisar a distribuição de tensões em um modelo 3D que simula a mesialização do segundo molar usando dois tipos diferentes de mini-implantes. Material e Métodos: um modelo de osso mandibular foi obtido por recomposição de uma tomografia computadorizada realizada por um software. O osso cortical e trabecular, um segundo molar inferior, ligamento periodontal, tubo ortodôntico, cimento resinoso e os mini-implantes foram projetados e modelados no software Rhinoceros 4.0. As características dos mini-implantes ortodônticos auto perfurantes foram: um com 7 mm de comprimento, 1 mm de secção transmucosa e 1,6 mm de diâmetro e outro com 5 mm de comprimento e 1,5 mm de diâmetro. Para a malha, foram utilizados 235.161 e 224.505 elementos. Esses modelos foram inseridos no bloco ósseo e então submetidos a cargas de 200 cN (centinewton). Os resultados foram calculados e analisados pelo software Ansys 17.0 para verificação qualitativa por meio de mapas de deslocamento e tensões máximas principais. Resultados: foi possível observar que o ligamento periodontal apresentou baixos valores de deslocamento e tensões. Porém, os valores fisiológicos apresentados são capazes de proporcionar movimentação ortodôntica, com visualização da área de compressão e tração escalonada entre 0,1 e -0,1 MPa (megapascal). Conclusão: dentro das limitações do estudo, os mini-implantes testados apresentaram resultados semelhantes onde a carga sobre o dente permitiu o deslocamento dentário (mesialização do molar), com tendência a girá-lo, permitindo teoricamente que o segundo molar ocupe do lugar do primeiro molar (AU)

Effects of Contamination by Hemostatic Agents and Use of Cleaning Agent on Etch-and-Rinse Dentin Bond Strength.

The aim of this study was to evaluate the influence of contamination by hemostatic agents and rinsing with chlorhexidine on bond strength between dentin and resin composite. Ninety-six bovine teeth were sectioned to expose a flat dentin surface area. A standardized cavity with 2.0 mm in thickness, superficial diameter of 4.0 mm and bottom diameter of 3.0 mm was prepared with a diamond bur in each dentin specimen. The teeth were divided into four groups according to the hemostatic employed: G1: control; G2: use of ViscoStat, Ultradent; G3: Hemosthasegel, FGM; and G4: Hemostop, Dentsply. The groups were divided into two subgroups according to the cleaning protocol method (n=12): A: without any further cleaning; and B: cleaning with chlorhexidine at 0.2%. All cavities were filled using a dentin adhesive and a resin composite, following the manufacturer's instructions. After 24 h, the specimens were aged by thermal and mechanical cycling. The bond strength was determined by the push out bond test (MPa), Statistical analysis was performed using two-way ANOVA and Tukey test (p<0.05). Statistically significant differences were detected among all groups treated with hemostatic agents and the control group. The post-hoc test showed that cleaning the cavity with chlorhexidine significantly improves the bond strength between dentin and resin composite. Our results suggested that the use of chlorhexidine can reestablish the bond strength between dentin and resin composite when a hemostatic agent was applied.

Influence of the addition of glass fibers reinforcements in the flexural strength of acrylic resin / Influência da adição de reforço de fibra de vidro na resistência flexural de resina acrílica

Objective: To evaluate the influence of glass fiber reinforcements used in nautical and sports products on the flexural strength of acrylic resin. Materials and methods: Thirty thermos activated acrylic resin bars (25 x 10.5 x 3.3 mm) were used. The samples were shared in 3 groups: bars with no glass fiber (control group, n = 10), bars reinforced with glass fiber and 0.18 mm thickness (group F1, n = 10) and bars reinforced with glass fiber and 0.80 mm thickness (group F2, n = 10). After 48 hours, samples were submitted to compression test in order to evaluate flexural strength. Obtained data were statistically analyzed with significance level of 5 %. Results: It was observed that the use of glass fiber effectively increased the flexural strength compared to the control group; the thickness of the glass fiber, however, did not present statistical differences. Conclusion: The use of fiber glass is a simple and cost-effective alternative to improve acrylic resin performance. (AU)

Objetivo: Avaliar a influência do reforço de fibra de vidro usada em produtos esportivos náuticos na resistência flexural da resina acrílica. Materiais e métodos: Trinta barras de resina acrílica termoativadas (25 x 10.5 x 3.3 mm) foram confeccionadas. As amostras foram divididas em 3 grupos: barras sem fibra de vidro (grupo controle, n = 10), barras com reforço de fibra de vidro com espessura de 0.18 mm (grupo F1, n = 10) e barras com reforço de fibra de vidro com espessura de 0.80 mm (grupo F2, n = 10). Após 48 horas, as amostras foram submetidas ao ensaio de compressão para avaliar a resistência flexural. Os dados obtidos foram analisados estatisticamente com nível de significância de 5%. Resultados: Foi observado que o uso de fibra de vidro aumentou efetivamente a resistência à compressão comparado com o grupo controle; a espessura da fibra de vidro, no entanto, não apresentou diferença estatisticamente significante. Conclusão: O uso de fibra de vidro é uma alternativa simples e de baixo custo para aprimorar a performance das resinas acrílicas. (AU)

The impact of at home and in-office bleaching agents on the color stability of bulk-fill composite resins / Impacto de agentes clareadores caseiros e de consultório na estabilidade de cor de resinas compostas bulk fill

Objective: This study compared different composites for color stability after exposure to at home and in-office bleaching gels. Material and Methods: Composite resin specimens (6mm diameterx2mm thickness) were manufactured according to the following groups (n=20): RC- Conventional; BF-Bulk Fill; RF-Flow; BFF-Bulk-Fill Flow. The surfaces were stained with coffee solution for 36h. A spectrophotometer was used to record the initial color (L*a*b*). Half of the specimens from each group underwent bleaching with 35% hydrogen peroxide (in-office) in three 45-minute applications. New color measurements were performed after 7, 14 and 21 days. The other half of the specimens underwent bleaching with 22% carbamide peroxide (at home) in 14 1-hour applications. Further color measurements were performed after 7 and 14 days. For comparison between the color coordinates in different periods, ANOVA for repeated measures was applied (α=5%). The color variation (ΔE) was calculated for each group. Results: For in-office bleaching, there were no significant differences between the periods b* coordinate of the RF group, and for L* and b* coordinates of the BFF group. For at home bleaching the groups BF and BFF showed no differences for the L* coordinate. For the other coordinates, there was difference between the initial periods and after 14 days. The ΔE variation presented higher values for the at home bleaching groups. For both whiteners the bulk-fill resins presented the greatest color variations. Conclusions: Bulk Fill resins do not guarantee greater color stability than the other composite resins tested, including conventional flow resin. The conventional composite resin showed the lower ΔE. (AU)

Objetivo: Esse estudo comparou diferentes resinas compostas quanto a estabilidade de cor após exposição a géis clareadores de uso caseiro e de consultório. Material e Métodos: Espécimes de resina composta (6mm diâmetro x 2mm espessura) foram confeccionados de acordo com os seguintes grupos (n=20): RC- Convencional; BFBulk Fill; RF-Flow; BFF-Bulk-Fill Flow. As superfícies foram manchadas com solução de café por 36 horas. Um espectrofotômetro foi utilizado para mensurar a cor inicial (L*a*b*). Metade dos espécimes de cada grupo foi submetida ao clareamento com peróxido de hidrogênio 35% (clareamento de consultório) durante três aplicações de 45 minutos. Novas mensurações de cor foram realizadas após as aplicações de 7, 14 e 21 dias. A outra metade dos espécimes foi submetida ao clareamento com peróxido de carbamida 22% (clareamento caseiro) em 14 aplicações de 1 hora durante 14 dias. Novas mensurações de cor foram realizadas após 7 e 14 dias. Para comparação entre as coordenadas nos diferentes períodos foi aplicada a análise de variância ANOVA para medidas repetidas (α=5%). A variação de cor (ΔE) foi calculada para cada grupo. Resultados: Para o clareamento de consultório não houve diferenças significativas para a coordenada b* do grupo RF, e para L* e b* no grupo BFF. Para o clareamento caseiro os grupos BF e BFF não apresentaram diferenças para a coordenada L*. Para as outras coordenadas, houve diferenças entre os períodos inicial e após 14 dias. A variação de ΔE apresentou maiores valores para o grupo submetido ao clareamento caseiro. Para ambos clareadores a resina composta bulk fill apresentou as maiores variações de cor. Conclusões: As resinas compostas bulk fill não garantiram uma maior estabilidade de cor quando comparadas as resinas compostas tradicionais testadas, incluindo a resina flow. A resina composta convencional apresentou a menor variação de ΔE. (AU)

Effects of Contamination by Hemostatic Agents and Use of Cleaning Agent on Etch-and-Rinse Dentin Bond Strength

Abstract The aim of this study was to evaluate the influence of contamination by hemostatic agents and rinsing with chlorhexidine on bond strength between dentin and resin composite. Ninety-six bovine teeth were sectioned to expose a flat dentin surface area. A standardized cavity with 2.0 mm in thickness, superficial diameter of 4.0 mm and bottom diameter of 3.0 mm was prepared with a diamond bur in each dentin specimen. The teeth were divided into four groups according to the hemostatic employed: G1: control; G2: use of ViscoStat, Ultradent; G3: Hemosthasegel, FGM; and G4: Hemostop, Dentsply. The groups were divided into two subgroups according to the cleaning protocol method (n=12): A: without any further cleaning; and B: cleaning with chlorhexidine at 0.2%. All cavities were filled using a dentin adhesive and a resin composite, following the manufacturer's instructions. After 24 h, the specimens were aged by thermal and mechanical cycling. The bond strength was determined by the push out bond test (MPa), Statistical analysis was performed using two-way ANOVA and Tukey test (p<0.05). Statistically significant differences were detected among all groups treated with hemostatic agents and the control group. The post-hoc test showed that cleaning the cavity with chlorhexidine significantly improves the bond strength between dentin and resin composite. Our results suggested that the use of chlorhexidine can reestablish the bond strength between dentin and resin composite when a hemostatic agent was applied.

Resumo O objetivo desse estudo foi avaliar a influência da contaminação por agentes hemostáticos e da lavagem com clorexidina na resistência de união entre dentina e resina composta. 96 dentes bovinos foram seccionados para a exposição de uma área plana de dentina. Em cada bloco, uma cavidade cônica de 2 mm de espessura, diâmetro externo de 4 mm e diâmetro interno de 3 mm, foi confeccionado com uma ponta diamantada. Os dentes foram divididos em 4 grupos de acordo com o hemostático empregado, como descrito: G1- controle, G2- uso de ViscoStat - Ultradent, G3- uso de Hemosthasegel - FGM, G4- uso de Hemostop - Dentsply. Os grupos foram divididos em 2 subgrupos de acordo com o protocolo de limpeza utilizado (n=12): A - nenhum agente de limpeza; B - limpeza com clorexidina 0.2%. Todas as cavidades foram preenchidas utilizando adesivo dentinário e resina composta, seguindo as instruções dos fabricantes. Após 24 h, os espécimes foram submetidos a protocolo de envelhecimento em cicladora termomecânica. A resistência de união foi determinada pelo teste mecânico de push-out (MPa), as análises estatísticas foram realizadas utilizando ANOVA 2-fatores e teste de Tukey (p<0.05). Diferenças estatisticamente significativas foram detectadas entre todos os grupos tratados com agentes hemostáticos e o grupo controle. O teste post-hoc mostrou que a limpeza da cavidade com clorexidina aumenta significativamente a resistência de união entre dentina e resina composta. Os resultados sugerem que o uso da clorexidina pode restabelecer a resistência de união entre dentina e resina composta quando um agente hemostático é aplicado.

Color stability of artificial teeth after exposure to acid and staining agents / Estabilidade de cor de dentes artificiais após a exposição a agentes ácidos e corantes

Alterações na cor dos dentes artificiais ocorrem principalmente devido à ingestão de bebidas e uso de produtos de limpeza e desinfecção de próteses. Soluções mais agressivas de limpeza devem ser identificadas e o paciente deve ser informado, a fim de evitar ou reduzir a frequência de seu uso, para maior longevidade de próteses. O objetivo deste estudo foi avaliar as alterações na cor de dentes artificiais antes e após imersão em bebidas e soluções desinfetantes. Material e Métodos: noventa e seis dentes artificiais de resina foram aleatoriamente divididos em 8 grupos. Cada grupo foi imerso por 10 min em uma solução de teste (café, suco de limão, gluconato de clorexidina, vinho tinto, refrigerantes à base de cola, vinagre ou antisséptico com e sem álcool) e, em seguida, os espécimes foram armazenados em saliva artificial durante 23 horas e 50 min, perfazendo um período de 24 h. Este procedimento foi realizado durante 14 dias consecutivos e depois desse período a segunda medição de cor foi feita. Os dados obtidos com o espectrofotômetro usando o CIEL * a * b * foram analisados através de ANOVA não paramétrico, Kruskal-Walis e o teste de Dunn. Resultados: Foram verificadas diferenças na variação de cor para cada grupo experimental após o desafio. As diferenças estatisticamente significativas foram encontradas entre os grupos de café, vinho tinto e suco de limão. Conclusão: Todas as substâncias mudaram a cor dos dentes artificiais; café foi a substância que causou mais descoloração dos dentes artificiais, alterando a cor e luminosidade; os antissépticos bucais com e sem álcool promoveram clareamento dos dentes artificiais...

Changes in color of artificial teeth mainly occur due to ingestion of beverages and use of products for cleaning and disinfection. More aggressive solutions must be identified and the patient provided with explanations in order to avoid or reduce the frequency of their use, to higher longevity of dentures. The purpose of this study was to evaluate changes in color of artificial teeth before and after immersion in beverages and disinfectants. Material and Methods: 96 artificial resin teeth were randomly divided into 8 groups. Each group was immersed for 10 min into a test solution (coffee, lemon juice, chlorhexidine gluconate, red wine, cola-based soft drink, vinegar or antiseptic with and without alcohol) and then the specimens were stored in artificial saliva for 23 h and 50 min, completing a period of 24 h. This procedure was performed for 14 consecutive days and after this period the second color measurement was made. Data obtained with the spectrophotometer using the CIEL*a*b* system were statistically analyzed using ANOVA non parametric, Kruskal-Walis and the Dunn test. Results: There were found differences in color variation for each experimental group after the challenge. Statistically significant differences were found among coffee, red wine and lemon juice groups. Conclusion: All substances changed the color of artificial teeth; coffee was the substance that caused most staining of artificial teeth, altering color and luminosity; the oral antiseptics with and without alcohol promoted whitening of the artificial teeth...

Removable partial or complete dentures exposed to beverages and mouthwashes: evaluation of microhardness and roughness / Próteses parciais e totais removíveis expostas a bebidas e enxaguatórios bucais: avaliação da microdureza e rugosidade

Purpose: To evaluate microhardness and roughness of denture base polymethylmethacrylate resinn exposed to acid beverages and mouthwashes. Material and method: Rectangular samples (n=80) were prepared from poly (methyl methacrylate) (PMMA). They were divided into 8 groups and had the initial microhardness and Knoop roughness measured. Samples of each group were immersed for 10 min into a test solution (coffee, lemon juice, chlorhexidine gluconate, red wine, cola-based soft drink, vinegar or antiseptic with and without alcohol) and after stored in artificial saliva for 23 h and 50 min, completing a period of 24 h. This procedure was performed for 14 consecutive days and after this period the microhardness and surface roughness measurements were made again. Data were statistically analyzed using ANOVA non parametric, Kruskal-Walis and the Dunn´s test for microhardness and the t-Student and ANOVA for roughness. Result: For microhardness there were found statistically significant differences among the chlorhexidine gluconate solution, antiseptic without alcohol and cola-based soft drink. For roughness was observed that the mean values between the initial period and after immersion in the test products differed statistically in all groups, without difference among groups. Conclusion: The microhardness of poly(methyl methacrylate) was affected by continue exposition to chlorhexidine gluconate, antiseptic without alcohol and cola-based soft drink. The roughness of poly(methyl methacrylate) is negatively influenced by the exposure to all tested products. It may be concluded that both, microhardness and roughness, were affected by the treatments.

Objetivo: Avaliar a rugosidade e microdureza de uma resina acrílica utilizada para base de prótese quando submetidas a diferentes bebidas e enxaguatórios bucais. Material e método: Oitenta amostras retangulares foram confeccionadas com polimetilmetacrilato, e separados em 8 grupos. As amostras foram avaliadas quanto à microdureza e rugosidade (Knoop) superficiais e imersas por 10 minutos em um dos seguintes produtos: café, suco artificial de limão, gluconato de clorexidina, vinho tinto, refrigerante a base de cola, vinagre e antissépticos com e sem álcool. Após a imersão nas soluções, as amostras foram acondicionados em saliva artificial por 23 horas e 50 minutos, completando o período de 24 horas. Esse procedimento ocorreu por 14 dias consecutivos e após esse período outras mensurações de microdureza e rugosidade foram realizadas. Os dados obtidos foram analisados estatisticamente pela ANOVA não paramétrico, Kruskal-Walis e teste de Dunn para a microdureza e ANOVA e t-student (alfa=5%) para rugosidade. Resultado: Para microdureza foram encontradas diferenças significativas entre os grupos onde houve imersão em clorexidina, antisséptico sem álcool e refrigerante de coca-cola. Para a rugosidade foi observado que a media entre os valores antes e após a imersão nos produtos diferiu estatisticamente em todos os grupos, porém sem diferença entre eles. Conclusão: A microdureza do polimetilmetacrilato foi afetada pela exposição ao gluconato de clorexidina, antisseptico sem álcool e refrigerante à base de coca-cola. A rugosidade da superfície do polimetilmetacrilato foi afetada por todos os produtos estudados.

Microdeformation of Infrastructure for Implant-Supported fixed Dental Prosthesis by Strain-Gauge Method: Influence of Technique and Material Impression

To verify the structural microdeformationby strain gages, around implants that have metal infrastructure, obtained by different materials and techniques impressions.Material and Methods:Three internal hexagon implants in polyurethane block (master model) with abutments were taken the impression with differents materials and techniques impression (n=4): addition silicon and transfer for open tray technique (Group I), condensation silicon and transfer for closed tray technique (Group II); and polyether and transfer for open tray techniques (GroupIII). Impressions were poured with type IV stone. Metallic infrastructure were made and installed in the master model by an aid of a manual ratchet wrench. A torque of 20N was used to install the metallic infrastructure. Microdeformation analysis was performed around the implants by strain gauge method. Two gauges were inserted into the polyurethane base, and three measurements were taken for each infrastructure. Data were analyzed using descriptive statistics and inference. Kruskal-Wallis test was used toverify association between materials and impression techniques and deformation around the implants, at 5% confidence.Results:Microdeformationsaround the implants showed no statistically significant difference (p = 0.123) between the experimental groups, Group I (215.8 με), Group II (194.9 με) and Group III (297.4 με). Conclusion:The use of different materials and techniques impression to madeof infrastructures for fixed implant-supported dental prosthesis did not present difference in microdeformation values around implants...

Evaluation of visual perception towards color selection of teeth from different populations by employing color scale, white light and different background contrasts / Avaliação da percepção visual na seleção de cor dos dentes em diferentes populações, empregando escala de cor, luz branca e contraste simultâneo de fundos

Objective: To evaluate the visual perception of dentistry professors, technicians and undergraduates on tooth color selection through varying the background contrast and tooth translucency. Material & Methods: Fifteen artificial teeth of different colors and translucencies were used and divided into three groups and placed onto cardboards in the following colors: white, red and black. Blindly, the observers (professors (n = 30), technicians (n = 30) and undergraduates (n = 30), selected the artificial tooth color that they judged compatible with VITA scale, when positioned onto the three background colors, at constant illumination through white artificial light. The obtained data were statistically analyzed by Kruskal-Wallis test. Results: There were no statistically significant differences among the studied populations in tooth color selection, regardless of the background colors, with all observers exhibiting a high number of errors. There were statistically significant differences in the number of matching answers among the studied teeth, with those exhibiting different translucencies showing the highest error rate (D1= 2 right answers; D4 = 0 right answers). Conclusion: Professional expertise was not decisive in tooth color selection; the number of matching answers of the three populations varied according to the background used; the most translucent teeth with different resin layers exhibited the smallest number of matching answers and the observers’ visual acuity differed and it should be effectively trained to achieve success in tooth color selection of prostheses and restorations

Objetivo: Avaliar a percepção visual na seleção de cor de dentes por professores de odontologia, técnicos de laboratório e alunos da graduação com contraste simultâneo de fundo. Material e Métodos: Foram utilizados 15 dentes de estoque de diferentes cores e translucidez, divididos em três grupos e posicionados em fundos de papel cartão nas cores: branco, vermelho e preto. Os observadores professores (n = 30), técnicos de laboratório (n = 30) e alunos (n = 30), selecionavam a cor dos dentes de estoque de diferentes cores, posicionados nas três cores de fundo, sempre com iluminação de luz artificial branca e comparavam com dentes da escala de cores. Após obtenção dos dados estes foram analisados pelo teste estatístico de Kruskal- Wallis. Resultados: os resultados mostraram que não existem diferenças estatisticamente significantes entre as populações estudadas, quando da seleção da cor dos dentes, independentemente das cores dos fundos e que o número de acertos foi muito pequeno, necessitando de melhor aprimoramento dos profissionais e alunos de graduação. Conclusão: Não houve diferença nos valores de acerto dos professores, alunos e técnicos de laboratório; a distribuição de acertos nos três diferentes fundos foi semelhante para os observadores; a porcentagem de erros entre os observadores foi muito elevada; a maior parte dos acertos diferiu conforme o dente avaliado, devido à maior translucidez e camadas de resina existentes e há necessidade de maior treinamento dos profissionais de odontologia para seleção das cores dos dentes.

Effect of activation mode on flexural strength in dual-polymerized resin cements / Efeito do modo de ativação na resistência a flexão de cimentos resinosos duais

Objective: To compare he influence of two activation modes on two similar dual-polymerized resin cements. Methods: Bars (2 × 2 × 12 mm) of RelyX ARC (3M ESPE, MN, USA) (ARC) and Enforce (Dentsply, Rio de Janeiro, Brazil) (ENF) were prepared, and three types of polymerization method were tested: (1) L: LED photoactivation/40 s; (2) H: halogen Light activations/40 s, and (3) C: chemical activation only (Complete absent of light). The groups were ARC-L; ARC-H, ARC-C, Enf-L, Enf-H, and Enf-C (n = 8). After 24 h, the specimens were tested using the 3-point bending method on a universal testing machine. Results: The ARC cement showed superior flexural strength results. The mode of activation revealed similar results on both cements tested, but lightactivated groups (with LED or Halogen light) showed higher flexural strength values than did the chemical-activation-only group. Conclusion: (1) RelyX ARC cement showed superior flexural strength when compared with Enforce; and (2) light activation resulted in better flexural strength values when compared to chemical activation on dual-polymerized resin cements.

Objetivo: Comparar a influência do modo de ativação de dois cimentos semelhantes, porém de fabricantes distintos. Métodos: Barras (2 x 2 x 12 mm) dos cimentos RelyX ARC (3M ESPE, MN, USA) e Enforce (Dentsply, Rio de Janeiro, Brasil) (ENF) foram confeccionadas com auxílio de uma matriz de teflon bipartida, e três modos de fotopolimerização foram testados: (1) L: fotoativação por LED / 40 segundos; (2) H - fotoativação por luz halógena / 40 segundos; e (3) Q - apenas ativação química (ausência total de luz). Os grupos formados foram: ARC-L; ARC-H; ARC-Q; Enf-L; Enf-H e Enf-Q, com 8 amostras cada. Após 24 horas, o teste de miniflexão de três pontos foi aplicado em máquina universal de testes. Resultados: O cimento ARC apresentou resultados de resistência superiores ao cimento Enf. O modo de ativação agiu de forma semelhante nos dois cimentos testados, sendo que a ativação por luz, seja L ou H, aumentou a resistência para ambos, comparada a ativação Q. Conclusão: (1) O cimento RelyX ARC (3M ESPE, MN, USA) apresentou maior resistência à flexão de três pontos quando comparado ao cimento Enforce(Dentsply, Rio de Janeiro, Brasil); e (2) a ativação por luz aumentou a resistência para cimentos resinosos duais.

Masticatory muscle activity evaluation by electromyography in removable partial denture users / Avaliação da atividade dos músculos da mastigação por eletromiografia em usuários de prótese parcial removível

Objectives: The aim of this study was to evaluate by electromyography the activity of the temporalis and masseter muscles in removable partial dentures (RPDs) users, before and after new RPDs installation. Material and Methods: Ten patients were selected for this study. All subjects were edentulous in the posterior mandibular region (Kennedy class I or II), fully dentate in the antagonist arch, and dental prosthesis users, which needed to be replaced. The electromyographic activity (EMG) recorded the superficial masseter and temporalis muscles, during the maximum voluntary bite force and the rest position. Maximum mouth opening was also verified. The measurements were recorded at four specific times: using the old prosthesis (T0), right after the new prosthesis installation (T1), two weeks (T2) and four weeks (T4) after installing the new prosthesis. All the RPDs were made by an experienced dentist and the same laboratory. Data were statistically analyzed by ANOVA and Tukey tests (α = 0.05). Results: EMG values had high standard deviation at the time T0. Generally, the mean values decreased after new prosthesis installation, especially after two weeks from the installation (T2). During the rest position, the left masseter and left temporalis muscles showed statistically significant gradual decrease in their activities over time. Conclusion: New prostheses have positive effect on the patient’s muscular activity. However, an adaptation period of the muscle fibers to the new prosthesis is needed

Objetivo: O objetivo deste estudo foi avaliar, através de eletromiografia, a atividade dos músculos masseter e temporal em usuários de próteses parciais removíveis (PPR), antes e depois da instalação da nova prótese. Materiais e Métodos: Dez pacientes foram selecionados para este estudo. Todos os indivíduos eram edêntulos na região mandibular posterior (Classes I e II de Kennedy), totalmente dentados no arco antagonista, e usuários de próteses removíveis, com necessidade de substituição. A atividade eletromiográfica (EMG) dos músculos masseter superficial e temporal foi verificada, durante as posições de contração máxima voluntária e repouso. A abertura bucal máxima também foi mensurada. As mensurações foram efetuadas em quatro momentos: durante a utilização da prótese antiga (T0), logo após a instalação da nova prótese (T1), duas semanas (T2) e quatro semanas (T4) após a instalação da nova prótese. Todas as próteses foram fabricadas por um único dentista com experiência e no mesmo laboratório. Os dados foram analisados estatisticamente pelos testes de ANOVA e Tukey (α = 0,05). Resultados: Os valores de EMG tiveram um alto desvio padrão no momento T0. Em geral, a atividade dos músculos mastigatórios sofreu uma diminuição após a instalação da prótese, especialmente após duas semanas da instalação (T2). Durante a posição de repouso, os músculos masseter e temporal esquerdos demonstraram um decréscimo gradual estatisticamente significativo em suas atividades ao longo do tempo. Conclusão: Novas próteses desempenham efeito positivo sobre a atividade muscular dos pacientes. Ainda, um período de adaptação das fibras musculares com a nova prótese se faz necessário.