RESUMEN
The esthetic treatment of darkened anterior teeth represents a great challenge to dentists, because dental materials ideally should match the natural teeth. The optical behavior of the final restoration is determined by the color of the underlying tooth structure, the color of the luting agent, and the thickness and opacity of the ceramic material used. This article reports a case in which veneers and full crowns made of heat-pressed, lithium disilicate glass-ceramic were used for the esthetic rehabilitation of anterior discolored teeth. The patient was referred for treatment with defective anterior composite resin restorations, provisional acrylic resin crowns, darkening of the gingival margins, and uneven gingival contours. The multidisciplinary treatment plan included dental bleaching, periodontal plastic surgery to create gingival symmetry, and indirect all-ceramic restorations using high-opacity lithium disilicate glass-ceramic ingots. The treatment was successful and an excellent esthetic result was achieved.
Asunto(s)
Coronas , Porcelana Dental/química , Coronas con Frente Estético , Estética Dental , Incisivo/patología , Decoloración de Dientes/rehabilitación , Adulto , Peróxido de Carbamida , Cerámica/química , Color , Resinas Compuestas/química , Materiales Dentales/química , Fracaso de la Restauración Dental , Restauración Dental Provisional , Femenino , Estudios de Seguimiento , Encía/patología , Gingivoplastia , Humanos , Planificación de Atención al Paciente , Peróxidos/uso terapéutico , Blanqueamiento de Dientes/métodos , Blanqueadores Dentales/uso terapéutico , Resultado del Tratamiento , Urea/análogos & derivados , Urea/uso terapéuticoRESUMEN
Introduction: To prevent the rate of water absorption and degradation of exposed collagen and the resin matrix on the hybrid layers, the use of an additional layer of hydrophobic resin on all-in-one adhesives is one of the approaches to improve the bond strength and infiltration of monomers in demineralized dentin. Objectives: To compare the microshear bond strength of different self-etching adhesive systems, and to evaluate the effect of the application of a hydrophobic adhesive layer on all-in-one adhesive systems after a storage period of 48 h and 30 days in distilled water at 37oC. Material and methods: Bovine incisor crowns were polished to expose flat dentin surfaces. The crowns were randomly distributed into 14 groups (n = 12) according to the adhesive system [Clearfil SE Bond (CSEB), AdheSE (ASE), Adper Scotchbond SE (SSE), Adper Easy Bond (EB), and Go! (GO)], and storage time. In two groups (indicated as GO+B and EB+B), a layer of a hydrophobic adhesive was applied on all-in-one adhesive systems. After 48h and 30 days of storage in distilled water at 37oC, microshear bond strength was determined. The data were statistically analyzed by ANOVA and Tukey's test (α = 5%). Results: After 48h, EB, EB+B, CSEB, and GO+B showed higher bond strength values. The application of a hydrophobic layer did not influence EB and increased GO bond strength values. After 30 days, CSEB, SSE, and EB+B showed the highest bond strength values. Comparing groups of all-in-one adhesives with and without a hydrophobic adhesive-resin layer, the bond strength values showed no significant difference. Conclusion: The application of a hydrophobic adhesive-resin layer increased bond strength values only at 48h. With respect to bond degradation over time, only EB showed a statistically significant decrease of bond strength after 30 days.