RESUMO
This study aimed to evaluate the effect of dentin hypersensitivity treatments on immediate and long-term shear bond strength (SBS) of composite restorations. Ninety non-carious extracted human molars were cut to expose dentin, which was embedded in acrylic resin, and randomly divided into three groups (n = 30/group) according to surface treatment: 1) no treatment (C and C*; control); 2) silver diamine fluoride with potassium iodide (SDF/KI and SDF/KI*; Riva Star); and 3) nano-hydroxyapatite (nHAp and nHAp*; PrevDent). The specimens were etched through the etch-and-rinse technique, followed by universal adhesive application and resin composite cylinders (2.38 mm in diameter × 3.5 mm high). The SBS was tested immediately (24 h after the restoration) and after thermocycling (*) (5000 cycles, 5 °C to 55 °C) at a 0.5 mm/min crosshead speed using a universal testing machine. A stereomicroscope was used to evaluate the mode of failure, and representative scanning electron microscopy (SEM) images were also acquired. Data normality was verified, and two-way ANOVA and Tukey's post hoc tests were performed for multiple comparisons (α = 0.05). The control group presented the highest SBS (27.10 MPa), while SDF/KI* had the lowest values (6.87 MPa). nHAp-based desensitizer exhibited higher SBS than SDF/KI for both immediate (22.6 MPa) and thermocycled (19.03 MPa) conditions. No intragroup difference was evidenced between immediate and thermocycled samples for any group. Most specimens for the C and nHAp groups presented mixed failure, while the SDF/KI groups presented comparable adhesive and mixed failures. The SBS of adhesive restorations after the application of desensitizing agents is material dependent, where SDF/KI reduces SBS values below the acceptable minimum bond strength, while the nHAp application meets the minimally required bond strength.
Assuntos
Colagem Dentária , Adesivos Dentinários , Humanos , Adesivos Dentinários/química , Colagem Dentária/métodos , Dentina , Pirenos , Teste de Materiais , Cimentos de Resina/química , Resistência ao CisalhamentoRESUMO
OBJECTIVES: Dentin hypersensitivity (DH) affects patients' oral health-related quality of life, but is not always optimally treated in dental offices. The objectives were to assess dentists' DH-related education, knowledge, and professional behavior and explore relationships between education, knowledge, and behavior. METHODS: Survey data were collected from 220 ADA members in the United States. Descriptive and correlational analyses were performed. RESULTS: About half of the respondents agreed/strongly agreed that their dental school had educated them well about diagnosing DH in classroom-based (53.6%) and clinical settings (48.9%). Lower percentages agreed being well educated about treating DH (40.9%/37.3%). The majority self-educated themselves about DH after dental school by attending continuing education courses in person or online (60.6%/36.8%), reading articles (64.1%), or consulting with colleagues (59.6%). The majority knew that patients with DH describe their pain as stimulated (91.4%) and that recessed gingiva (89.6%), abrasion lesions (72.3%), tooth whitening (63.1%), erosion lesions (58.6%), and abfraction lesions (51.4%) are risk factors for DH. The majority diagnosed DH with patient self-reporting, confirmed by exams (81.8%), applying air blasts (53.7%), or cold-water (52.3%). They treated patients with DH often/very often with over-the-counter desensitizing agents (90%), and prescribing fluoride formulations toothpaste (82.8%) and/or potassium nitrate toothpastes (60.9%). In their offices, the majority (73.2%) educated their patients often/very often about DH and used fluoride dental varnish for treating DH (71.8%). The more recently respondents had graduated from dental school, the more positively they described their dental school education (r = 0.14; p < 0.05), the more ways to diagnose DH they used (r = 0.16; p < 0.05) and the more often they used fluoride dental varnish in their offices (r = 0.23; p < 0.001). The more dentists had educated themselves, the more methods for diagnosing DH they used (r = 0.23; p < 0.001) and the more often they used potassium oxalate products (r = 0.19; p < 0.01), Arginine/calcium products (r = 0.19; p < 0.01) and dentin bonding (r = 0.22; p < 0.001). CONCLUSIONS: More recently graduating from dental school correlates with more positive evaluations of DH-related dental school education. The finding that most dentists engage in self-education about DH after dental school should motivate dental educators to increase education about this topic not only in dental school, but also in continuing education courses.