Evaluation of compatibility between different types of adhesives and dual-cured resin cement.

PURPOSE: The objective of this in vitro study was to evaluate the bonding compatibility between different adhesives and a dual-cured resin cement, using a conventional tensile bond test. MATERIALS AND METHODS: The adhesives used were: Prime & Bond (PB) (Dentsply) (PB), Scotchbond Multi Purpose (SB) (3M), and the activator Self Cure (SC) (Dentsply). The dual-curing resin cement used was Enforce (EF) (Dentsply). Six groups with five specimens in each were tested: G1: EF/PB/EF (light cured); G2: EF/SB/EF (light cured); G3: EF/PB+SC/EF (light cured); G4: EF/PB+SC/EF (only chemically cured); G5: EF/EF (light cured); G6: EF/EF (only chemically cured). The resin cement was applied in two stainless steel molds with a cone-shaped perforation measuring 4 mm in diameter and 1 mm in thickness, and the adhesive was applied between them. Ten minutes after specimens were cured, the tensile strength was measured in a universal testing machine at a crosshead speed of 0.5 mm/min. RESULTS: The mean values (MPa) +/- SD obtained in each experimental group were: G1: 1.4 +/- 0.2; G2: 1.3 +/- 0.2; G3: 1.2 +/- 0.4; G4: 0.8 +/- 0.2; G5: 1.2 +/- 0.1; G6: 0.7 +/- 0.1. The results were statistically evaluated using nonparametric Kruskal-Wallis and Dunn tests (p < or = 0.05). Statistically significant differences among groups were found only between G1 and G4, and G1 and G6. CONCLUSION: There was no incompatibility among the different adhesives used with dual-cured resin cement. The lowest tensile bond strength values occurred in the absence of photoactivation.

Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach.

OBJECTIVES: This paper reports on a longitudinal evaluation of three materials (glass ionomer, zinc oxide-eugenol cement, and composite) employed in a minimal restorative intervention approach of 81 high caries-active pregnant women selected for a preventive oral health program in Brazil. The aim of the study was to evaluate the clinical behavior of the glass ionomer cement, currently indicated in programs for control of carious lesions. METHODS: The patients were randomly divided into two groups. Both groups were engaged in an oral health promotion approach. In Group 1, 417 glass ionomer restorations were placed in 43 individuals, involving all types and sizes of cavities. In the second group, 213 posterior zinc oxide-eugenol (ZOE) restorations and 127 anterior composite restorations were placed in 38 patients. Minimal cavity preparations were made, in which only soft or infected dentin was removed, on the basis of clinical judgment. RESULTS: After two years, the restorations were clinically evaluated by two examiners for marginal integrity, amount of wear, presence of fracture, carious lesions, and lost restorations. Statistical analysis (chi-square test) identified statistically significant difference between glass ionomer and ZOE (90.6% vs 9.2%). Comparing glass ionomer and composite, similar survival rates were observed. The success rate observed for the glass ionomer cement ranged from 77.1 percent to 92.5 percent, depending on the type and size of cavity in which it was applied. Four teeth restored with glass ionomer cement and one tooth restored with composite showed caries signs. Regarding the ZOE restorations, caries was always associated with other causes of failure such as excessive wear, restoration loss, or marginal defects, with no possibility of separate evaluation. Despite the preventive and therapeutic measurements employed, a mean increase of 2.15 new surfaces with cavities was observed in Group 1, as well as 2.83 surfaces presenting the same status in Group 2. CONCLUSIONS: This study demonstrated that highly viscous glass ionomer cement applied in a minimal intervention approach provided high-quality preventive and restorative care after two years to a population at high risk for caries. The composite was employed in cavities exposed to lower stress, such as in the anterior teeth, and its behavior was comparable to that of the glass ionomer cement. The reinforced ZOE presented a high failure rate, thus contraindicating its use for such purpose.

Fracture resistance of teeth directly and indirectly restored with composite resin and indirectly restored with ceramic materials.

PURPOSE: To evaluate the fracture resistance of teeth restored with direct and indirect restorations of composite resin and restored with indirect ceramic restorations. MATERIAL AND METHODS: Fifty-six maxillary premolar teeth were chosen and divided at random into seven equal groups; Group 1 (control): intact teeth; Group 2: MOD cavity preparations, 1/2 intercuspal distance, with rounded internal angles, convergent walls, unrestored; Group 3: MOD cavity preparations, 1/2 intercuspal distance, divergent walls; Group 4: same preparation as Group 2, restored with direct composite resin (Single Bond/Filtek Z250-3M); Group 5: same as Group 3, restored with indirect composite resin (Artglass/Single Bond/Rely X); Group 6: same as Group 3, restored with indirect composite resin (Targis/Single Bond/Rely X); Group 7: same as Group 3, restored with indirect ceramic restoration (Empress/Single Bond/Rely X). The specimens were subjected to a compressive axial loading in a Universal testing machine at 0.5 mm/minute by means of a steel bar (8 mm in diameter). RESULTS: The mean fracture strength obtained was: Group 1: 1.91 kN; Group 2: 1.06 kN; Group 3: 0.93 kN; Group 4: 1.45 kN; Group 5: 1.81 kN; Group 6: 1.81 kN; Group 7: 1.77 kN. The restored teeth with direct composite restoration increased the fracture resistance of Group 4 up to 76% of a level comparable with the intact teeth (Group 1). However, statistical analysis indicated no significant (P < 0.05) differences between Group 1 (intact teeth) and restored teeth groups, with direct restorations as well as indirect restorations. Both cavity preparation designs weakened the remaining tooth structure. These results demonstrated that a bonded indirect restoration could satisfactorily be an ideal option for restoring teeth weakened by wide cavity preparation.

Clinical evaluation of two packable posterior composites: a five-year follow-up.

BACKGROUND: Research has suggested that packable resin-based composites inserted with a placement technique similar to amalgam condensation can reduce the sensitivity associated with posterior restorations. The authors evaluated the clinical performance, including associated sensitivity, of two packable composites in a randomized five-year clinical trial. METHODS: A single operator randomly placed two restorations in each of 33 patients: one restoration consisting of Alert (Jeneric/Pentron, Wallingford, Conn.) and the other consisting of SureFil (Dentsply/Caulk, Milford, Del.). There were 30 Class I and 36 Class II restorations. Two independent evaluators evaluated the restorations by using modified U.S. Public Health Service criteria. The authors analyzed data by means of the Fisher, chi(2) and McNemar tests at P < .05. RESULTS: Of 60 restorations evaluated at five years, two Class II restorations (one SureFil, one Alert) failed. All other restorations received the highest score possible for sensitivity and vitality. The only difference between the composites at the five-year recall was the significantly better surface texture of SureFil. The authors observed significantly different scores between the baseline and at five years for marginal discoloration (Alert and SureFil), surface texture (Alert and SureFil) and color (SureFil). CONCLUSIONS: Both packable resin-based composites showed excellent durability during the five-year follow-up. CLINICAL IMPLICATIONS: The investigated resin-based composites are suitable for posterior restorations.