Crown Material and Occlusal Thickness Affect the Load Stress Dissipation on 3D Molar Crowns: Finite Element Analysis

PURPOSE: To compare the mechanical behavior (stress load dissipation and/or concentration) of posterior crowns made from Lava Ultimate (LU; 3M ESPE) and IPS e.max CAD (LD; Ivoclar Vivadent) using finite element analysis (FEA). MATERIALS AND METHODS: A 3D model of a mandibular first molar was prepared by reducing the occlusal surface by 1 or 2 mm (according to group), the axial walls by 1.5 mm, and using a 0.8-mm-deep shoulder margin as a finish line. A convergence of 6 degrees between opposing walls was set. Subsequently, four 3D crown models were created according to two test groups with two different occlusal thicknesses: (1) LD with 1.0 mm (LD1); (2) LD with 2.0 mm (LD2); (3) LU with 1.0 mm (LU1); and (4) LU with 2.0 mm (LU2). FEA models were constructed using the software Femap (Siemens). A load of 200 N was applied in the axial and oblique (20 degrees) directions for each group, and stress dissipation was viewed using the NEi Nastran software. RESULTS: FEA results demonstrated that the LU crowns dissipated the occlusal load to the tooth structure, whereas the LD material concentrated the load inside the crowns. For the LU material, the lower the occlusal thickness, the higher the stress concentration inside the crown became, and the 2.0-mm occlusal thickness transferred lower stress to the tooth structure. The oblique, rather than the vertical, load caused an increase in the maximum stress concentration at the shoulder margin and axial walls. CONCLUSION: The higher the Young's Modulus mismatch between the crown material and substrate, the higher the load stress concentration inside the material became. The 2-mm occlusal thickness acted by decreasing the load stress to the tooth substrate. Finally, the axial load delivered more favorable stress transmission to the tooth substrate. The crown material and the occlusal thickness appear to be two factors that affect the mechanical behavior of stress dissipation to the tooth structure.

The influence of final endodontic irrigation techniques and irrigants on the push-out resistance of glass fiber posts.

This study evaluated the influence of different combinations of 3 final endodontic irrigation techniques (positive-pressure irrigation [PPI], passive ultrasonic irrigation [PUI], and continuous ultrasonic irrigation [CUI]) and 2 irrigants (5.25% sodium hypochlorite [NaOCl] and 2% chlorhexidine [CHX]) on the push-out resistance of glass fiber posts. Ninety bovine roots were prepared and divided into 6 groups (n = 15): PPIN, PPI with 5.25% NaOCl; PUIN, PUI with 5.25% NaOCl; CUIN, CUI with 5.25% NaOCl; PPIC, PPI with 2% CHX; PUIC, PUI with 2% CHX; and CUIC, CUI with 2% CHX. In the PPI groups, a 30-gauge needle was used to deliver the irrigating solution. In the PUI groups, a 30-gauge needle was used to deliver the irrigating solution, which was activated for 10 seconds by means of a stainless steel file mounted on an ultrasonic unit. In the CUI groups, delivery and continuous agitation of the irrigating solution for 10 seconds were performed using a stainless steel file mounted on the ultrasonic unit. After canal preparation was completed, glass fiber posts were cemented with a dual-cure resin cement. The roots were sectioned into 1-mm-thick slices (coronal, middle, and apical thirds). After 7 days' storage in distilled water, the slices were submitted to a push-out test. The mean bond strength values were compared using 2-way analysis of variance and Tukey post hoc test (P < 0.05). The mean (SD) overall bond strength values of the specimens were as follows: PPIN, 4.46 (1.43) MPa; PUIN, 6.13 (2.35) MPa; CUIN, 7.41 (1.83) MPa; PPIC, 3.59 (1.70) MPa; PUIC, 5.49 (1.41) MPa; and CUIC, 6.0 (1.63) MPa. Irrespective of the irrigating solution, continuous ultrasonic irrigation achieved significantly greater push-out bond strengths for glass fiber posts, mainly at the apical third of the root specimens (P < 0.05).

Is the at-home bleaching treatment applied only on the lingual surface as effective as that on the buccal surface? A randomized clinical trial.

OBJECTIVES: This double-blind randomized clinical trial compared the effectiveness and bleaching sensitivity (BS) of at-home dental bleaching performed on the buccal surface and on the lingual surface. METHODS: Using a split-mouth design, 25 patients were assigned to two bleaching groups: 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the buccal surface (BSB) and 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the lingual surface (LSB), both for 14 days. The color was evaluated before bleaching, after the first and second weeks, and 1 month after the bleaching using Vita Classical and Vita Bleachedguide scales and a Vita Easyshade spectrophotometer. BS was recorded daily using a 0-4 numerical rating scale and a 0-10 visual analogue scale. The following statistical tests were used: color changes (Mann-Whitney), absolute risk of BS (McNemar's exact), and the intensity of BS (Mann-Whitney). In all statistical tests, the significance level was 5%. RESULTS: Significant bleaching was observed after the end of bleaching in both groups, with higher bleaching effectiveness for BSB when compared to LSB (p < 0.05). Regarding BS, no significant difference was observed between groups (p = 1.00). CONCLUSIONS: The 10% hydrogen peroxide (White Class 10%, FGM) applied in at-home bleaching performed on the lingual surface did not promote a similar result of color change compared to on the buccal surface. Regarding BS, there was no significant difference between the groups. CLINICAL RELEVANCE: The at-home bleaching performed on the lingual surface promotes a lower result in the color change. BS is similar between the groups. CLINICAL TRIAL REGISTRATION NUMBER: RBR-283byt.

The effectiveness of in-office dental bleaching with and without sonic activation: A randomized, split-mouth, double-blind clinical trial.

OBJECTIVE: This study was aimed at comparing the bleaching efficacy and bleaching sensitivity (BS) of two higher-concentration in-office bleaching gels (37% carbamide peroxide [CP] and 38% hydrogen peroxide [HP]) applied under two conditions: alone or in association with sonic activation. METHODS: Fifty-six volunteers were randomly assigned in the split-mouth design into the following groups: CP, CP with sonic activation (CPS), HP, and HP with sonic activation (HPS). Two in-office bleaching sessions were performed. Color was evaluated using Vita Classical, Vita Bleachedguide, and digital spectrophotometer at baseline and at 30 days post-bleaching. Absolute risk and intensity of BS were recorded using two pain scales. All data were evaluated statistically (color changes [t test], BS [Chi-square and McNemar test], and BS intensity [VAS; t test; NRS; Wilcoxon; α = 0.05]). RESULTS: Significant and higher whitening was observed for HP when compared with CP (p < 0.04). However, higher BS intensity was observed in the former (p < 0.001). No significant difference was observed in whitening effect or BS when the HP or CP bleaching gels were agitated (sonic application) compared with when they were not (p > 0.05). CONCLUSION: The 37% CP gel demonstrated lower bleaching efficacy and lower BS compared with the 38% HP bleaching gel. The whitening effect was not influenced by the use of sonic activation. CLINICAL SIGNIFICANCE: The use of 37% CP gel did not achieve the same whitening effect when compared to 38% HP gel used for in-office bleaching. The use of sonic activation offers no benefit for in-office bleaching.

Evaluation of the genotoxic potential of different delivery methods of at-home bleaching gels: a single-blind, randomized clinical trial.

OBJECTIVE: This single-blind, parallel, randomized clinical trial evaluated the genotoxic potential and effectiveness of 10% hydrogen peroxide (HP) in patients submitted to at-home bleaching. MATERIALS AND METHODS: Sixty young volunteers with maxillary incisors equal to or darker than M1.5 were included in the study. Patients were submitted to bleaching for 14 days (30 min/day) with one of the three 10% HP treatments: the bleaching agent was delivered in a bleaching tray (White Class, FGM), whitening strips (White Strips, Oral-b), or in prefilled disposable trays (Opalescence Go, Ultradent). The color change was evaluated with the Vita Bleachedguide, and the micronucleus test of exfoliative oral mucosa was carried out, starting from a count of 1000 cells, at the baseline, immediately after and 30 days after the end of the treatment. The micronucleus data were evaluated with the Kruskal-Wallis and Wilcoxon tests and color change with the two-way ANOVA test and the Tukey test (α = 0.05). RESULTS: Significant whitening was observed for all groups after 14 days (p = 0.001) and was maintained after 30 days, with no difference between groups (p = 0.42). The micronucleus count did not indicate genotoxic potential in any of the groups studied (p = 0.32), irrespective of the time intervals (p = 0.62). CONCLUSION: No genotoxic effects of 10% HP were observed in patients submitted to at-home bleaching systems (30 min/day for 14 days), even 30 days after the end of treatment. CLINICAL SIGNIFICANCE: It is safe to use different systems to deliver 10% HP during at-home bleaching according to the manufacturers' recommendations, with no risk of genotoxic effects applied.

Noninvasive esthetic treatment for hypomaturation amelogenesis imperfecta: a case report.

Enamel alterations, such as amelogenesis imperfecta, can compromise the harmony of the smile and the patient's self-esteem and may cause tooth sensitivity. A simple and effective treatment approach uses the natural stratification of composite resins to mask deficient enamel formation and mimic the natural appearance of the substrate. The operative steps and principles for restorative success are described in this case report with 36-month follow-up.

The role of emergence profile in papilla maintenance after diastema closure with direct composite resin restorations.

The dental morphology usually determines the shape and volume of the interdental space, which must be filled by a dense connective tissue covered by oral epithelium to achieve pleasant esthetics. When composite resin restorations are placed to solve esthetic problems, the restorative procedure must be designed to allow the formation of healthy interdental papilla. This case report discusses aspects that should be considered when composite resin restorations are proposed for diastema closure. A 23-year-old man sought treatment for variations of space in the anterior dentition after orthodontic treatment. Direct composite resin restorations were placed in a way that respected the emergence profile, even though "black triangles" were evident immediately after the procedure. At the 45-day follow-up, complete closure of the interdental spaces by healthy papillae was observed. The emergence profile should be identified and respected when restorations are placed to obtain diastema closure because healthy periodontal tissues and acceptable esthetics depend on it.

Effect of whitening dentifrices on the surface roughness of a nanohybrid composite resin.

OBJECTIVES: The present study verified the influence of whitening dentifrices on the surface roughness of a nanohybrid composite resin. MATERIALS AND METHODS: Thirty-two specimens were prepared with Filtek™ Z350 XT (3M/ESPE) and randomly divided into four groups (n = 08) that were subjected to brushing simulation equivalent to the period of 1 month. The groups assessed were a control group with distilled water (G1), Colgate Total 12 Professional Clean (G2), Sensodyne Extra Whitener Extra Fresh (G3), and Colgate Luminous White (G4). A sequence of 90 cycles was performed for all the samples. The initial roughness of each group was analyzed by the Surface Roughness Tester (TR 200-TIME Group Inc., CA, USA). After the brushing period, the final roughness was measured, and the results were statistically analyzed using nonparametric Kruskal-Wallis and Dunn tests for intergroup roughness comparison in the time factor. For intragroup and "Δ Final - Initial" comparisons, the Wilcoxon test and (one-way) ANOVA were, respectively, performed (α = 0.05). RESULTS: The roughness mean values before and after brushing showed no statistically significant difference when the different dentifrices were used. None of the dentifrices analyzed increased significantly the nanohybrid composite resin surface roughness in a 1 month of tooth brushing simulation. CONCLUSIONS: These results suggest that no hazardous effect on the roughness of nanohybrid composite resin can be expected when whitening dentifrices are used for a short period. Similar studies should be conducted to analyze other esthetic composite materials.

Esthetic rehabilitation with tooth bleaching, enamel microabrasion, and direct adhesive restorations.

The aim of this case report is to report esthetic rehabilitation with combined tooth bleaching, enamel microabrasion, and anterior restoration replacement in a 26-year-old man. Clinical examination showed deficient restorations in the maxillary anterior teeth, significant discoloration of the maxillary left central incisor, and hypoplastic stains affecting the maxillary right lateral incisor. A radiograph of the left central incisor showed satisfactory endodontic treatment, allowing preparation for the walking bleach technique. For 3 weeks, 37% carbamide peroxide in the pulp chamber was renewed every week. In-office bleaching with 35% hydrogen peroxide was also performed on the maxillary teeth. After 21 days, all teeth had been bleached to shade A1. After bleaching was completed, enamel microabrasion of the maxillary right lateral incisor was conducted with 6% hydrochloric acid. In later sessions, microhybrid composite resin restorations were placed in all 4 maxillary incisors. A combination of dental bleaching techniques, enamel microabrasion, and resin restorations was a successful and conservative choice for reestablishing the natural appearance of discolored teeth, improving the self-esteem of the patient.

Amazonian delicacy tucupi is as erosive as a cola-based soft drink.

OBJECTIVE: Acidic diets are advocated as main risk factor for tooth erosion, which could be prevented, or at least controlled, if patients were early advised. It is important to identify, hence, if possible dietary constituents regionally consumed on large scale, such as tucupi, a low-pH yellowish-green color and strong flavor delicacy made from the juice of a bitter cassava, may explain its occurrence in specific patient groups. This cross-over in situ/ex vivo study evaluated tucupi's ability to promote erosion of bovine enamel by assessing its percentage of surface microhardness change (%SMHC), taking a cola-based soft drink and human saliva as positive and negative controls. DESIGN: For three 7-days spaced out legs of 7 days each, nine volunteers wore palatal devices with three bovine enamel blocks, which were challenged with one of the following solutions: TUC-tucupi (n=27); COL-cola-based soft drink (n=27); SAL-saliva (n=27). Erosive challenges were performed extra-orally (4×/day) by dropping TUC or COL at room temperature on specimens. After 5min, palatal devices were replaced into the mouth. SAL permanently acted as the negative control while volunteers solely wore the device. One-way ANOVA followed by Tukey's post-hoc tests (α=0.05) were applied. RESULTS: TUC promoted an enamel %SMHC (-21.56±10.08(a)) similar than that promoted by COL (-18.19±12.99(a); p=0.275), which were both significantly higher than that promoted by SAL (-1.86±13.65(b); p<0.0001). CONCLUSIONS: Besides the most worldwide appreciated cola-based soft drink, the greatly consumed Amazonian delicacy tucupi can be considered a potential risk factor for tooth erosion.

Bond strength of a resin composite and a resin-modified glass-ionomer cement associated or not with chlorhexidine to eroded dentin / Resistência de união de uma resina composta e um cimento de ionômero de vidro modificado por resina com e sem a aplicação de clorexidina à dentina erodida

Objetivo: Apesar da resina composta e o cimento de ionômero de vidro serem amplamente usados para restaurações cervicais, sob condições erosivas estas podem desgastar mais rapidamente. Este estudo objetivou comparar a resistência adesiva ao microcisalhamento de uma resistência de união (RC) e um cimento de ionômero de vidro modificado por resina (RMGIC) à dentina erodida associada à Clorexidina 2% num período de até 6 meses. Material e Métodos: Oitenta terceiros molares humanos foram cortados e uma dentina regular foi obtida, e subsequentemente, foram inclusos com resina acrílica em tubos de PVC. Os dentes foram divididos em dois grupos, de acordo com o tratamento recebido: Adper Single Bond 2 + RC Filtek Z250 (Z) ou RMGIC Vitremer (V). Metade dos corpos de prova foram imersos em saliva artificial (AS) por 24 h (grupo controle) e metade foi erodido artificialmente 3x/1 min diariamente com Coca Cola ®-RC por 5 dias. Metade dos corpos de prova, para cada condição descrita, recebeu água e outra metade a clorexidina 2% por 1 min, antes da restauração. Para todos os grupos, os corpos de prova foram armazenados em saliva artificial renovada semanalmente até os testes. A resistência de união ao microcisalhamento foi avaliado após 1 e 6 meses. Os resultados foram analisados com teste ANOVA 4 critérios e Tukey (p < 0,05). Resultados: Os fatores materiais, substrato e tempo foram estatisticamente significantes, além da interação entre o material e o tempo. O tratamento (água X clorexidina) não foi um fator significante. As restaurações com Z demonstraram resistência de união significantemente maior comparada ao V, em todas as situações. Conclusão: Tanto para a dentina sadia quanto erodida, a resina composta apresentou maior resistência de união comparada ao cimento de ionômero de vidro. O tempo e uso da clorexidina não interferiu na resistência de união. A resina composta demonstrou maior resistência adesiva quando comparada ao cimento de ionomero de vidro.

Objective: Although resin composites and glassionomer cements are widely used for dental cervical region restorations, under erosive condition they can wear out quickly. This study aimed to compare, by means of microshear bond strength, the performance of a resin composite (RC) and a resin-modified glassionomer cement (RMGIC) to eroded dentin and its association with 2% chlorhexidine (CHX) up to 6 months. Material and Methods: Eighty sound third molars teeth were cut to obtain flat coronal dentin, which were subsequently embedded in self-curing acrylic resin circular molds. Teeth were divided into two groups, according to the treatment with the Adper Single Bond 2 + RC Filtek Z250 (Z) or the RMGIC Vitremer (V). Half of the specimens were immersed in artificial saliva-AS (control groups) and half subjected to 3x/1 min daily immersion in Regular Coca Cola ®-RC for 5 days. Half of the specimens for each described condition were treated with water and half with 2% chlorhexidine for 1 min prior the restoration. For all groups, the specimens were stored in artificial saliva weekly renewed up to tests. The microshear bond strength was evaluated after 1 month and 6 months. Data, in normal distribution, were analyzed with four-way ANOVA and Tukey (p < 0.05). Results: The factors materials, substrate and time were statistically significant and also the interaction between material and time. Treatment (water x CHX) was not a significant factor. Restorations with Z showed significantly higher bond strength compared to V in all situations. There was a reduction in bond strength values over time for all tested conditions. Conclusion: For both sound and eroded dentin, the resin composite presented higher bond strength compared to resin-modified glassionomer material. The bond strength performance was overall reduced with time and the use of chlorexidine itself did not interfere on bond strength through time...

Effect of sealants in the composite surface roughness after tooth brushing / Efeito de selantes na rugosidade de resinas compostas após a escovação simulada

This in vitro study evaluated the influence of 4 surface sealers on the surface roughness of composite resins. Fifty specimens were divided into 10 groups, as follows: G1. (Control 1) Concept resin; G2. Concept + Fortify; G3. Concept + Biscover; G4. Concept + Lasting Touch; G5. Concept + Fill Glaze; G6. (Control 2) Esthet X; G7. Esthet X + Fortify; G8. Esthet X + Biscover; G9. Esthet X + Lasting Touch; G10. Esthet X + Fill Glaze. Specimens (15mm in length, 4 mm in depth and 5 mm in width) were made using a matrix and were stored in distilled water at 37ºC for 24 hours. After storage, specimens were polished using 320, 600 abrasive SiC paper under running water and the initial roughness was measured using a perfilometer. Surface sealers were applied and a new measurement of roughness was made. Specimens were submitted to 100,000 cycles of abrasive dentifrice brushing followed by another surface roughness measurement. Qualitative analysis was made by using SEM. Results were submitted to 3-way modified ANOVA (p<0.05) and Tukey's test. Results: Surface sealant provided smoother surfaces for both tested composite resins (G2=0.0727, G3=0.0147, G4=0.0307, G5=0.0253, G7=0.0173, G8=0.0333, G9=0.0480, G10=0,0480). After the abrasion test, the control group presented lower roughness surface (G1=0.0600, G6=0.1007). No statistical difference were found between Fortify (G2=0.0740, G7=0.0673) and Biscover (G7=0.0440). Lasting Touch presented rougher surfaces in relation to the other groups (G4= 0.1253, G9=0.0980), followed by Fill Glaze (G5=0.0933, G10= 0.0847). The application of surface sealant did not provide roughness optimization after tooth brushing simulation for the 2 composite resins tested.

Este estudo avaliou, in vitro, a influência de 4 selantes de superfície na rugosidade de duas resinas compostas. Cinqüenta espécimes foram confeccionados e divididos em 10 grupos com 5 espécimes cada, em função da combinação entre resina composta e selante de superfície, sendo: G1. Controle Concept; G2. Concept + Fortify; G3. Concept + Biscover; G4. Concept + Lasting Touch; G5. Concept + Fill Glaze; G6. Controle Esthet X; G7. Esthet X + Fortify; G8. Esthet X + Biscover; G9. Esthet X + Lasting Touch; G10. Esthet X + Fill Glaze. Os espécimes (15mm X 4 mm X 5 mm) foram confeccionados e armazenados em água destilada à 37ºC por 24 horas. Após este período, os espécimes foram planificados com lixas de granulometria 320, 600 e a rugosidade inicial foi aferida. Aplicaram-se os selantes de superfície e uma nova aferição da rugosidade superficial foi realizada. Os espécimes foram submetidos a 100.000 ciclos de escovação, seguido de nova mensuração da rugosidade. Os resultados foram submetidos aos testes ANOVA a 3 critérios e Tukey. A aplicação do selante de superfície diminuiu a rugosidade superficial das resinas compostas testadas (G2=0,0727, G3=0,0147, G4=0,0307, G5=0,0253, G6=0,0960, G7=0,0173, G8=0,0333, G9=0,0480). Nenhuma diferença estatística foi encontrada entre o grupo Fortify (G2=0,0740, G7=0,0673) e Biscover (G7=0,0440). Os maiores valores de rugosidade foram apresentados pelo grupo Lasting Touch (G4= 0,1253, G9=0,0980), seguido do Fill Glaze (G5=0,0933, G10= 0,0847). A aplicação do selante de superfície não otimizou a rugosidade das duas resinas compostas testadas após o teste de abrasão simulada.

Conservative approach to restore the first molar with extensive destruction: A 30-month follow-up.

The available options for restoring multiple surface cavities are: amalgam, composite resin, or indirect restorations. Adhesive system and intradentinal pin-retained composite resin restorations should have a similar performance to pin-retained amalgam, regarding resistance to support occlusal forces. Polymerization shrinkage is a major concern when performing direct posterior composite resin restorations and the incremental insertion technique can provide less stress and outstanding margin behavior. Intradentinal pins can potentially enhance composite resin's retention, while reducing gaps caused by polymerization shrinkage. This article reports a clinical case involving an extensive restoration on a posterior tooth with cusp loss that was successfully treated using an intradentinal pin and direct nano-hybrid composite resin restoration.

Influência da solução de clorexidina a 2% na resistência adesiva de pinos de fibra de vidro em raízes bovinas: acompanhamento imediato, 6 meses e 1 ano / 2% chlorhexidine influence on fiber posts bond strength to bovine roots: immediate, 6-month and 1-year-aging

Este trabalho teve como objetivo avaliar a influência da solução de clorexidina a 2% na resistência adesiva de pinos de fibra de vidro cimentados com cimento resinoso convencional utilizando três diferentes sistemas adesivos (2 convencionais e 1 autocondicionante), no período de 7 dias, 6 meses e 1 ano. Foram selecionadas 180 raízes bovinas, que foram tratadas endodonticamente e divididas em 6 grupos (n=30): MP, sistema adesivo (SA) convencional de 3 passos (ScotchBond Multi Uso); SB, SA convencional de 2 passos (Single Bond); SE, SA autocondicionante de 2 passos (Clearfil SE Bond); MP-CHX, SB-CHX e SE-CHX, com aplicação da clorexidina (CHX). Em todos os grupos, o pino de fibra de vidro Exacto foi cimentado com cimento resinoso dual RelyX ARC. Cada grupo foi dividido em 3, de acordo com o período experimental, 7 dias, 6 meses e 1 ano (n=10). Após a obtenção de fatias com 1mm de espessura, os espécimes foram submetidos ao teste de push-out (100kg, 0,5mm/min). Os tipos de falhas foram analisados em microscópio ótico de luz (40x) e classificados em: adesiva cimento/dentina; adesiva cimento/pino; coesiva em dentina ou cimento, e mista. Os valores, convertidos em MPa, foram analisados pelo teste ANOVA a 4 critérios e teste de Tukey para comparação das médias, com nível de significância de 5%. Não houve diferença estatística com o uso da CHX para os SAs convencionais testados, nos períodos de 7 dias, 6 meses e 1 ano (p>0,05). Dentre os SA, o MP foi o que se manteve constante com ou sem CHX (p>0,05). Houve diminuição de resistência adesiva no terço cervical, em 1 ano, e no terço apical em 7 dias do SE-CHX (p<0,05). Pode-se concluir que o uso da CHX pareceu não interferir na resistência adesiva dos SAs testados, exceto para o SA autocondicionante, em 7 dias e 1 ano.

The aim of this work was to evaluate the 2% chlorhexidine influence on fiber posts bond strength luted with a resin cement, with three different dentin bonding systems (2 etch-and-rinse and 1 self-etching), with 7-day, 6-month and one-year-aging. One hundred and eighty bovine roots were endodontically treated and randomly assigned to 6 groups (n=30): MP, three-step etch-and-rinse dentin bonding system (DBS) (ScotchBond Multi Uso); SB, two-step etch-and-rinse DBS (Single Bond); SE, twostep self-etching DBS (Clearfil SE Bond); MP-CHX, SB-CHX and SE-CHX, with chlorhexidine (CHX) application. Exacto fiber posts were luted with dual cure resin cement RelyX ARC in all groups. Each group was divided in three, according to aging (n=10). After obtainning 1mm-thick slices, push-out test was carried out (100kg, 0,5mm/min). Failure modes were assessed under light microscopy (40x) and classified in: adhesive to dentin; adhesive to post; cohesive in dentin or cement, and mixed failure. Values were converted to MPa and analyzed by 4-way ANOVA and Tukeys test for multiple comparisons, at 5% significance level. There was no difference with the use of CHX for tested etch-and-rinse DBSs, after 7-day, 6-month and one-year-aging (p>0,05). Among DBSs, MP presented constant values (p>0,05). SE-CHX presented significant lower bond strength values on the cervical third, at one year, and apical third at 7 days (p<0,05). It can be concluded that CHX use seemed not to interfere bond strength values of all materials tested, except for the self-etch DBS, after 7 days and one year-aging.

Influência da solução de clorexidina a 2% na resistência adesiva de pinos de fibra de vidro em raízes bovinas: acompanhamento imediato, 6 meses e 1 ano / 2% chlorhexidine influence on fiber posts bond strength to bovine roots: immediate, 6-month and 1-year-aging

Este trabalho teve como objetivo avaliar a influência da solução de clorexidina a 2% na resistência adesiva de pinos de fibra de vidro cimentados com cimento resinoso convencional utilizando três diferentes sistemas adesivos (2 convencionais e 1 autocondicionante), no período de 7 dias, 6 meses e 1 ano. Foram selecionadas 180 raízes bovinas, que foram tratadas endodonticamente e divididas em 6 grupos (n=30): MP, sistema adesivo (SA) convencional de 3 passos (ScotchBond Multi Uso); SB, SA convencional de 2 passos (Single Bond); SE, SA autocondicionante de 2 passos (Clearfil SE Bond); MP-CHX, SB-CHX e SE-CHX, com aplicação da clorexidina (CHX). Em todos os grupos, o pino de fibra de vidro Exacto foi cimentado com cimento resinoso dual RelyX ARC. Cada grupo foi dividido em 3, de acordo com o período experimental, 7 dias, 6 meses e 1 ano (n=10). Após a obtenção de fatias com 1mm de espessura, os espécimes foram submetidos ao teste de push-out (100kg, 0,5mm/min). Os tipos de falhas foram analisados em microscópio ótico de luz (40x) e classificados em: adesiva cimento/dentina; adesiva cimento/pino; coesiva em dentina ou cimento, e mista. Os valores, convertidos em MPa, foram analisados pelo teste ANOVA a 4 critérios e teste de Tukey para comparação das médias, com nível de significância de 5%. Não houve diferença estatística com o uso da CHX para os SAs convencionais testados, nos períodos de 7 dias, 6 meses e 1 ano (p>0,05). Dentre os SA, o MP foi o que se manteve constante com ou sem CHX (p>0,05). Houve diminuição de resistência adesiva no terço cervical, em 1 ano, e no terço apical em 7 dias do SE-CHX (p<0,05). Pode-se concluir que o uso da CHX pareceu não interferir na resistência adesiva dos SAs testados, exceto para o SA autocondicionante, em 7 dias e 1 ano.

The aim of this work was to evaluate the 2% chlorhexidine influence on fiber posts bond strength luted with a resin cement, with three different dentin bonding systems (2 etch-and-rinse and 1 self-etching), with 7-day, 6-month and one-year-aging. One hundred and eighty bovine roots were endodontically treated and randomly assigned to 6 groups (n=30): MP, three-step etch-and-rinse dentin bonding system (DBS) (ScotchBond Multi Uso); SB, two-step etch-and-rinse DBS (Single Bond); SE, twostep self-etching DBS (Clearfil SE Bond); MP-CHX, SB-CHX and SE-CHX, with chlorhexidine (CHX) application. Exacto fiber posts were luted with dual cure resin cement RelyX ARC in all groups. Each group was divided in three, according to aging (n=10). After obtainning 1mm-thick slices, push-out test was carried out (100kg, 0,5mm/min). Failure modes were assessed under light microscopy (40x) and classified in: adhesive to dentin; adhesive to post; cohesive in dentin or cement, and mixed failure. Values were converted to MPa and analyzed by 4-way ANOVA and Tukeys test for multiple comparisons, at 5% significance level. There was no difference with the use of CHX for tested etch-and-rinse DBSs, after 7-day, 6-month and one-year-aging (p>0,05). Among DBSs, MP presented constant values (p>0,05). SE-CHX presented significant lower bond strength values on the cervical third, at one year, and apical third at 7 days (p<0,05). It can be concluded that CHX use seemed not to interfere bond strength values of all materials tested, except for the self-etch DBS, after 7 days and one year-aging.

Do the microshear test variables affect the bond strength values?

Little is known about the effect of specimen preparation and testing protocols on the micro-shear bond strength (µSBS) results. To evaluate whether variations in polyethylene rod use affect (µSBS)). Human dentin disks were randomly distributed into six groups (n = 5): polyethylene tube (3 levels) and adhesive system (2 levels). In Group 1, polyethylene tubes filled with polymerized composite) were placed on adhesive covered surfaces. Tubes were removed 24 h after water storage, leaving the rods only. In Group 2, the same procedure was performed; however, tubes were kept in place during testing. In Group 3, composite rods without tubes were placed on adhesive covered dentin. In all groups, adhesives were photoactivated after positioning filled tubes/rods on adhesive covered surfaces. Specimens were tested under shear mode and the data subjected to a two-way ANOVA and Tukey's tests. Groups 1 and 2 resulted in statistically similar mean µSBS (P > 0.05); however, a greater number of pretest failures were observed for Group 1. Higher µSBS values were detected for Group 3, irrespective of adhesive system used (P < 0.05). Removing the polyethylene tube before composite rod is placed on dentin affects µSBS values.

Internal fit of two all-ceramic systems and metal-ceramic crowns.

OBJECTIVES: The aim of this study was to investigate the internal fit (IF) of glass-infiltrated alumina (ICA--In-Ceram Alumina), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP--IPS e.max ZirCAD), and metal-ceramic (MC--Ni-Cr alloy) crowns. MATERIAL AND METHODS: Sixty standardized resin-tooth replicas of a maxillary first molar were produced for crown placement and divided into 3 groups (n=20 each) according to the core material used (metal, ICA or Y-TZP). The IF of the crowns was measured using the replica technique, which employs a light body polyvinyl siloxane impression material to simulate the cement layer thickness. The data were analyzed according to the surfaces obtained for the occlusal space (OS), axial space (AS) and total mean (TM) using two-way ANOVA with Tukey's multiple comparison test (p<0.05). RESULTS: No differences among the different areas were detected in the MC group. For the Y-TZP and ICA groups, AS was statistically lower than both OS and TM. No differences in AS were observed among the groups. However, OS and TM showed significantly higher values for ICA and Y-TZP groups than MC group. Comparisons of ICA and Y-TZP revealed that OS was significantly lower for Y-TZP group, whereas no differences were observed for TM. CONCLUSIONS: The total mean achieved by all groups was within the range of clinical acceptability. However, the metal-ceramic group demonstrated significantly lower values than the all-ceramic groups, especially in OS.

Internal fit of two all-ceramic systems and metal-ceramic crowns

OBJECTIVES: The aim of this study was to investigate the internal fit (IF) of glass-infiltrated alumina (ICA - In-Ceram Alumina), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP - IPS e.max ZirCAD), and metal-ceramic (MC - Ni-Cr alloy) crowns. MATERIAL AND METHODS: Sixty standardized resin-tooth replicas of a maxillary first molar were produced for crown placement and divided into 3 groups (n=20 each) according to the core material used (metal, ICA or Y-TZP). The IF of the crowns was measured using the replica technique, which employs a light body polyvinyl siloxane impression material to simulate the cement layer thickness. The data were analyzed according to the surfaces obtained for the occlusal space (OS), axial space (AS) and total mean (TM) using two-way ANOVA with Tukey ’s multiple comparison test (p<0.05). RESULTS: No differences among the different areas were detected in the MC group. For the Y-TZP and ICA groups, AS was statistically lower than both OS and TM. No differences in AS were observed among the groups. However, OS and TM showed significantly higher values for ICA and Y-TZP groups than MC group. Comparisons of ICA and Y-TZP revealed that OS was significantly lower for Y-TZP group, whereas no differences were observed for TM. CONCLUSIONS: The total mean achieved by all groups was within the range of clinical acceptability. However, the metal-ceramic group demonstrated significantly lower values than the all-ceramic groups, especially in OS.

Cavity instrumentation with chemical vapor deposition diamond-coated bur / Instrumentação cavitária com uso de ponta diamantada obtida pela tecnologia da Deposição Química por Vapor

High- and low-speed rotary dental handpieces have been used for a long time in restorative dentistry for cavity preparation. However, problems inherent to conventional burs, such as noise, heat and vibration, have led to the development of new dental burs, such as the chemical vapor deposition diamond-coated bur. Its advantages are many, such as less noise, less pain for the patient, precise cutting, conservative cavity preparation, longer lifetime, less injury to the dental structures, no cutting of soft tissues and easier access of the carious lesion. This case report uses a chemical vapor deposition diamond-coated bur to prepare a cavity by direct proximal access, preserving the marginal ridge. The cavity was then filled with glass ionomer cement. The clinical outcome was satisfactory. Direct access to the cavity was possible because of the chemical vapor deposition diamond-coated bur, resulting in comfort for the patient and dentist.

Os instrumentos rotatórios convencionais têm sido utilizados em alta e/ou baixa velocidade há tempos para a confecção de cavidades na odontologia restauradora. Contudo, problemas inerentes a estes equipamentos, como o ruído, calor e vibração mecânica levaram ao desenvolvimento de novos instrumentos, como a ponta de diamante pela tecnologia Deposição Química por Vapor. Esta apresenta uma série de vantagens como menor ruído, procedimento menos doloroso, desgaste preciso e preparo conservador, maior durabilidade da ponta, menor injúria à estrutura dentária, não corta os tecidos moles e acesso facilitado à lesão cariosa. Este trabalho apresenta um relato de caso clínico demonstrando o uso da ponta de diamante Deposição Química por Vapor para a confecção de um preparo cavitário proximal com acesso direto, com preservação da crista marginal, restauração com cimento de ionômero de vidro. O resultado clínico satisfatório foi conseguido, com acesso direto à cavidade em detrimento à configuração das pontas utilizadas, proporcionando conforto para o paciente e cirurgião dentista.

Conservative approach for a clinical resolution of enamel white spot lesions.

Enamel white spot lesions in anterior teeth that compromise esthetics are common. Microabrasion is indicated, since it affects enamel superficially. An acid-abrasive slurry with 37% phosphoric acid with pumice was used on the enamel for a controlled time period. Home bleaching with hydrogen peroxide was then used, further improving the final result. The method is safe, easy, and conservative and provides good esthetic results.