Investigations on the adhesion of new composites for restoring cervical lesions using energy dispersive X-ray analysis and scanning electron microscopy.

Restoration of noncarious cervical lesions with resin composites is one of the treatment options, but the retention of the restorations located at the crown-root junction is still a cause of clinical concern. The aim of this study was to evaluate the adhesive properties of three experimental resin composites and two commercial materials used to restore cavities prepared on extracted teeth as well as to determine the relative elemental composition of these materials. We tested the null hypothesis, which considered that the adhesive behaviours of different resin composites did not differ. The microleakage test using tracers showed that all tested materials exhibited some degree of dentinal microleakage, although they all had good dentinal adhesion. The results failed to reject the null hypothesis. The scanning electron microscopy revealed completely adapted adhesive interfaces underneath the restorations along with well-developed hybrid layers depending on the adhesive system. Energy dispersive X-ray analysis analyses showed that the restorative materials have similar chemical compositions, with some differences between the samples from the same material. The results support the implementation of experimental resins in clinical settings.

Patient-centered outcomes after subepithelial connective tissue grafts and coronally advanced flaps.

OBJECTIVE: The use of a coronally advanced flap (CAF) and connective tissue graft (CTG) is a well-established procedure to cover single and multiple recessions and improve soft tissue esthetics. However, until now, there are still limited data evaluating patient morbidity, the fear of imminent tooth loss, and modification of sensitivity in surgical areas. The aim of the present study was to evaluate the patient-centered outcomes associated with CAF + CTG. METHOD AND MATERIALS: Thirty-four patients (mean age, 30.76 ± 6.88 years) with single or multiple Class I and II gingival recessions were treated using a CAF + CTG. The following parameters were evaluated at 14 days and 1, 3, 6, and 12 months after surgery: esthetics, root hypersensitivity, fear of imminent tooth loss, daily activities or nutritional habits, and the levels of postsurgical morbidities. A visual analog scale was used to evaluate patient-centered outcomes. The percentage of patients belonging to each of the severity scales, the mean values associated with each parameter, and the statistical significance of the modification of the monitored parameters were calculated. The parametric F (Fisher) test and the least significant difference post hoc pair-wise comparisons were computed. RESULTS: There were statistically significant differences between baseline and all follow-up time points in root hypersensitivity and in fear of tooth loss. Preoperative prevalence of fear of tooth loss was 99%. Esthetics were statistically significantly improved at the 1-, 3-, 6-, and 12-month visits compared with the evaluation at 14 days. No palatal bleeding was recorded. The pain perception in the donor area was mild: Only 3% of patients reported severe palatal pain, and the mean VAS score for palatal pain was 3.79 ± 1.49. CONCLUSION: Treatment of single and multiple gingival recessions with CAF + CTG resulted in predictable improvements of soft tissue esthetics and root hypersensitivity but was associated with a slight increase in patient morbidity, mainly related to the harvesting of CTG. This should be considered when treating patients with esthetic demands.