Restablecimiento de guía anterior con restauraciones adhesivas / Reestablishing of anterior guidance with adhesive restorations

La estética ha llegado a formar una parte muy importante en la odontología actual. Sin embargo, no debemos sobreponer las necesidades estéticas sobre las necesidades funcionales. La pérdida de estructura dental asociada a bruxismo puede ser considerada patológica cuando compromete la guía anterior, la cual es la influencia en los movimientos mandibulares que proveen las superficies contactantes de los dientes maxilares anteriores con los mandibulares anteriores y evita contactos excéntricos dañinos en los dientes posteriores. El objetivo de este reporte de caso es presentar una alternativa conservadora para restablecer tanto la estética como la funcionalidad de una paciente de 34 años de edad que acudió a la Clínica de Prostodoncia de la Universidad Autónoma de Guadalajara en busca de rehabilitación estética de dientes anteriores. Una vez realizada su evaluación inicial se llegó al diagnóstico de pérdida de guía anterior por desgaste patológico asociado a bruxismo. El tratamiento incluyó tratamientos de conductos, remoción de caries y restauraciones mal ajustadas, coronas y carillas para restablecer la guía anterior. Se cumplieron con las expectativas estéticas que tenía la paciente al igual que con las necesidades funcionales que fueron objetivo desde el inicio, logrando un restablecimiento de la guía anterior de manera conservadora (AU)

Esthetics has become a very important part of dentistry today. However, we should not superimpose esthetic needs over functional needs. The loss of tooth structure associated with bruxism can be considered pathologic when it compromises the anterior guidance, which is the influence on mandibular movements that provides the contacting surfaces of the maxillary anterior teeth with the mandibular anterior teeth and avoids damaging eccentric contacts in the posterior teeth. The aim of this case report is to present a conservative way to restore both esthetics and function in a 34-year-old patient who came to the Prosthodontics Clinic of the Universidad Autónoma de Guadalajara in search of an esthetic appearance of her anterior teeth. After her initial evaluation, a diagnosis of anterior guide loss due to pathological wear associated with bruxism was made. Treatment included root canal treatment, removal of caries, and ill-fitting restorations, crowns, and veneers to reestablish the anterior guidance. The aesthetic expectations of the patient have met as well as the functional needs that were aimed from the beginning, achieving a conservative reestablishment of the anterior guidance system (AU)

Influência da utilização de ácido glicólico e adesivos universais na qualidade da camada híbrida em restaurações adesivas: revisão de literatura / Influence of the use of glycolic acid and universal adhesives on the quality of the hybrid layer in adhesive restorations: literature review

A camada híbrida é definida pela zona de inter difusão do polímero do adesivo e o substrato dental. Os sistemas adesivos universais são materiais que foram criados com o intuito de substituir a estrutura dental que foi perdida a fim de diminuir essa área de interação adesiva e os espaços desmineralizados da dentina. O objetivo do seguinte estudo é realizar uma revisão de literatura acerca da influência dos adesivos universais e o uso do ácido glicólico como condicionante dental. Foi realizada uma busca na literatura atual, nas seguintes bases de dados: PubMed, Scielo, Medline e Google Acadêmico nos idiomas inglês e português usando os termos de pesquisa: "adhesive systems" AND "phosphoricacid" OR/AND "glycolicacid" OR/AND "hybridlayer" OR/AND "universal adhesive system". As pesquisas realizadas utilizando o ácido glicólico como agente condicionante dental demonstraram que a substância tem potencial e efetividade, diminuindo consideravelmente a região de fibras colágenas expostas para a fusão do adesivo universal. O ácido glicólico utilizado como agente condicionante de esmalte e dentina mostrou-se eficaz e promissor, tendo em vista que a camada híbrida se apresentou com menor espessura sem alterar a estrutura dentinária. Porém, faz-se necessário mais pesquisas utilizando o ácido glicólico juntamente com o sistema adesivo universal, por curto, médio e longo prazo.

The hybrid layeri s defined by the interdiffusion zone of the adhesive polymer and the dental substrate. Universal adhesive systems are materials that have been created with the aim of replacing the tooth structure that has been lost in order to reduce this area of adhesive interaction and the demineralized spaces of dentin. The aim of the following study is to perform a literature review on the influence of universal adhesives and the use of glycolic acid as a dental conditioning agent. A search was conducted in the current literature in the following databases: PubMed, Scielo, Medline and Google Scholar in English and Portuguese using the search terms: "adhesive systems" AND "phosphoric acid" AND "glycolic acid" AND "hybrid layer" OR "universal adhesive system". Research using glycolic acid as a dental conditioning agent has shown that the substance has potential and effectiveness, considerably reducing the region of collagen fibers exposed for the fusion of the universal adhesive. Glycolic acid used as a conditioning agent for enameland dent inproved to be effective and promising, considering that the hybrid layer was presented with less thickness without altering the dentin structure. However, further research his needed usinggly colic acid together with the universal adhesive system, for short, medium and long term.

Effect of saliva contamination and different decontamination protocols on microshear bond strength of a universal adhesive to dentin / Efeito da contaminação por saliva e de diferentes protocolos de descontaminação na resistência de união ao microcisalhamento de um adesivo universal à dentina

Objective: To evaluate the effect of saliva contamination and different decontamination protocols on the microshear bond strength of a universal adhesive to dentin. Material and Methods: 84 bovine teeth were divided into three groups according to bonding stage at which salivary contamination occurred; before curing of the adhesive, after curing of the adhesive, and a control group with no salivary contamination. Each group was further subdivided into four subgroups according to the decontamination protocol used (n=7): no decontamination protocol, rinsing then reapplication of the adhesive, grinding with sandpaper silicon carbide grit 600 then reapplication of the adhesive and finally ethanol application then reapplication of the adhesive. Specimens were tested in micro-shear mode. Results: All the decontamination protocols used in this study to reverse effect of salivary contamination before curing significantly improved the bond strength to contaminated dentin (p<0.001). Meanwhile, after curing, ethanol decontamination protocol recorded highest bond strength followed by rinsing and grinding compared to no decontamination (p<0.001). Conclusion: Saliva contamination led to significant deterioration in the bond strength regardless of the bonding stage at which saliva contamination occurred. All decontamination protocols improved the immediate microshear bond strength when contamination occurred before curing of the adhesive, while ethanol seemed to be the most effective both before curing and after curing (AU)

Objetivo: Avaliar o efeito da contaminação por saliva e de diferentes protocolos de descontaminação na resistência de união ao microcisalhamento de um adesivo universal à dentina. Material e Métodos: 84 dentes bovinos foram divididos em três grupos de acordo com o passo operatório do protocolo adesivo em que ocorreu a contaminação por saliva: antes da polimerização do adesivo, ou após a polimerização do adesivo e um grupo controle sem contaminação por saliva. Cada grupo foi subdividido em quatro subgrupos de acordo com o protocolo de descontaminação utilizado (n=7): sem protocolo de descontaminação; lavagem seguida da reaplicação do adesivo; lixar a região com lixa de carbeto de silício de granulação 600 e reaplicar o adesivo; aplicar etanol e reaplicar o adesivo. Os espécimes foram testados no modo de micro-cisalhamento. Resultados: Todos os protocolos de descontaminação utilizados neste estudo em busca de reverter o efeito da contaminação do adesivo por saliva melhoraram significativamente a resistência de união à dentina contaminada (p<0,001). Enquanto isso, após a polimerização, o protocolo de descontaminação com etanol resultou na maior resistência de união, seguido pela lavagem, e depois pelo lixamento, em comparação com nenhum protocolo de descontaminação (p<0,001). Conclusão: A contaminação por saliva levou a uma deterioração significativa na resistência de união, independentemente do passo operatório do protocolo adesivo em que ocorreu a contaminação por saliva. Todos os protocolos de descontaminação melhoraram a resistência de união ao microcisalhamento imediato quando a contaminação ocorreu antes da polimerização do adesivo, enquanto o etanol pareceu ser o protocolo mais eficaz nos dois tipos de contaminação (antes e depois da polimerização).

Bond strength of composite resin/universal adhesive to dentin submitted to radiotherapy / Fuerza de unión de resina compuesta/adhesivo universal a dentina sometida a radioterapia

Aim: To evaluate the bond strength of a universal adhesive system to dentin submitted to radiotherapy. Materials and Methods: Sixty extracted human teeth were divided into two groups (n = 30): without radiotherapy (control); with radiotherapy, according to the adhesive protocol (n=15): ER-etch-and-rinse (acid + Single Bond Uni-versal); SE-self-etch (Single Bond Universal). The analyzes were shear bond strength (SBS) (n=10), failure pattern (n=10) and scanning electron microscopy (n=5). Data was analyzed by a two-way ANOVA (α =0.05). Results: The radiotherapy decreased SBS of the restorative material to dentin (p<0.0001). The ER protocol provided lower bond strength values (p<0.001). The predominant type of fracture without radiotherapy was mixed (SE), cohesive to the material (ER). Both protocols presented adhesive failures with radiotherapy. Teeth had a hybrid layer and long resin tags (without radiotherapy) and few tags (with radiotherapy). Conclusions: The SE adhesive mode favors the shear bond strength of resin to dentin in teeth submitted to radiotherapy.

Objetivo: Evaluar la fuerza de adhesión de un sistema adhesivo universal a la dentina sometida a radioterapia. Materiales y Métodos: Sesenta dientes humanos extraídos se dividieron en dos grupos (n = 30): sin radioterapia (control); con radioterapia, según protocolo adhesivo (n=15): ER-grabado y enjuague (ácido + Single Bond Universal); autograbado SE (Single Bond Universal). Los análisis ejecutados fueron resistencia al cizallamiento (SBS) (n=10), patrón de falla (n=10) y microscopía electrónica de barrido (n=5). Los datos se sometieron al test de ANOVA de dos vías (α =0,05). Resultados: La radioterapia disminuyó la SBS del material restaurador a la dentina (p<0,0001). El protocolo ER proporcionó valores de fuerza de unión más bajos (p<0,001). El tipo de fractura predominante sin radioterapia fue mixta (SE), cohesiva al material (ER). Ambos protocolos presentaron fallas adhesivas con radioterapia. Los dientes tenían una capa híbrida y colas de resina largas (sin radioterapia) o pocas colas de resina (con radioterapia). Conclusión: El modo adhesivo SE favorece la resistencia al corte de la resina a la dentina en dientes sometidos a radioterapia.

Bond strength comparison among 10-MDP-containing and non-10-MDP-Containing adhesives in different degrees of dental fluorosis / Comparación de fuerza de unión entre adhesivos que contienen y no contienen 10-MDP en diferentes grados de fluorosis dental

Dental fluorosis can cause changes in the enamel surface, conditioning its functionality and esthetics. The application of dental adhesives is a treatment option; however, their use on fluorotic teeth can result in limitations. The aim of this study was to compare the shear bond strength of two different adhesives, one with 10-MDP and one without 10-MDP, in different degrees of dental fluorosis.This is an in vitro study on dental enamel samples, a total of 180 samples with the inclusion criteria were treated, randomly divided into two groups of 90, according to the type of dental adhesive, where each group was again divided into three groups of 30 samples, representing different degrees of dental fluorosis according to the Thylstrup-Fejerskov index (Group I: TF1 and TF2; Group II: TF3; Group III: TF4). Normality tests, two-factor ANOVA, and post-hoc tests were used to determine differences between the groups, with a significance level of 95%. As results, a statistically significant difference was shown between the use of dental adhesive with 10-MDP and the three groups of dental fluorosis (p=0.011), in addition, a Tukey post-hoc test on the groups treated with 10-MDP adhesive revealed a statistically significant difference between group I versus group II, and group I versus group III, (p=<0.05). It is concluded that the use of adhesive systems with 10-MDP presents a better shear bond strength on enamel with dental fluorosis grades I and II in the Thylstrup-Fejerskov index.

La fluorosis dental puede ocasionar cambios en la superficie del esmalte, condicionando su funcionalidad y estética, la aplicación de adhesivos dentales es una opción de tratamiento, sin embargo, su uso en dientes fluoroticos puede resultar en limitaciones. El objetivo de este estudio consistió en comparar la fuerza de adhesión a la cizalladura de dos diferentes adhesivos, uno con 10-MDP y otro sin 10-MDP, en diferentes grados de fluorosis dental. Se trata de un estudio in vitro en muestras de esmalte dental, un total de 180 muestras con los criterios de inclusión fueron tratadas, aleatoriamente divididas en dos grupos de 90, de acuerdo al tipo de adhesivo dental, donde cada grupo fue dividido nuevamente en tres grupos de 30 muestras, representando diferentes grados de fluorosis dental según el índice de Thylstrup- Fejerskov (Grupo I: TF1 y TF2; Grupo II: TF3; Grupo III: TF4). Para determinar diferencias entre los grupos se utilizaron pruebas de normalidad, ANOVA de dos factores, y pruebas post-hoc, con un nivel de significancia de 95%. Como resultados, se mostró una diferencia estadísticamente significativa entre el uso de adhesivo dental con 10- MDP y los tres grupos de fluorosis dental (p=0.011), además, una prueba post hoc de Tukey sobre los grupos tratados con adhesivo 10-MDP revelaron una diferencia estadísticamente significativa entre el grupo I frente al grupo II, y el grupo I frente al grupo III, (p=<0.05) Se concluye que el uso de sistemas adhesivos con 10-MDP presentan una mejor resistencia de adhesión al cizallamiento en esmalte con grados de fluorosis dental I y II en el índice de Thylstrup-Fejerskov

Efecto de diferentes condiciones y modos de aplicación sobre la fuerza de unión de los adhesivos a la dentinaEffect of different conditions and modes of application on bond strength of adhesives to dentine / Effect of different conditions and modes of application on bond strength of adhesives to dentine

Objective: To evaluate the microtensile bond strength in different dentine conditions (etched-E, non-etched-N, dry-D and wet-W) of a multimode adhesive (Scotchbond Universal-SU, 3M/ESPE) and a total etching adhesive (Ambar-AB, FGM) using a sonic device (Smart Sonic Device-SD, FGM). Material and methods: In this in vitro study, ninety six sound extracted human molars were divided into 12 groups (n=8) according to different dentine conditions and adhesive systems. Enamel was removed and the middle dentine surfaces were polished. Each adhesive system was applied according to the different dentine conditions, and composite resin blocks were incrementally built up and stored for 24 hours. Specimens were sectioned into sticks and bond strength data were analyzed with the Kruskal-Wallis test and Mann-Whitney U tests. Results: No effects of sonic application and were observed. In general, AB showed lower results compared to the SU. E and N conditions did not statistically affect the bond strength of SU groups. Dry dentine presented statistically superior bond strength values when compared to wet dentine for SU/E/SD group. Conclusion: Adhesion of dry dentine with multimode adhesive system may be superior to wet dentine with sonic application. The modes of application had no influence in bond strength of studied adhesives.

Objetivo: Evaluar la resistencia de la unión microtensil en diferentes condiciones de dentina (grabado-E, sin grabado-N, seco-D y húmedo-W) de un adhesivo multimodo (Scotchbond Universal-SU, 3M/ESPE) y un adhesivo de grabado total (Ambar-AB, FGM) utilizando un dispositivo sónico (Smart Sonic Device-SD, FGM). Material y Métodos: En este estudio in vitro, noventa y seis molares humanos extraídos sanos se dividieron en 12 grupos (n=8) de acuerdo con diferentes condiciones de dentina y sistemas adhesivos. Se eliminó el esmalte y se pulieron las superficies centrales de la dentina. Cada sistema adhesivo se aplicó de acuerdo con las diferentes condiciones de dentina, y los bloques de resina compuesta se acumularon de forma incremental y se almacenaron durante 24h. Las muestras se seccionaron en barras y los datos de resistencia de la unión se analizaron con la prueba de Kruskal-Wallis y la prueba de U de Mann-Whitney. Resultado: No se observaron efectos de la aplicación sónica. En general, AB mostró resultados más bajos en comparación con el SU. Las condiciones E y N no afectaron estadísticamente la fuerza de unión de los grupos SU. La dentina seca presentó valores de fuerza de adhesión estadísticamente superiores en comparación con la dentina húmeda para el grupo SU/E/SD. Conclusión: La adhesión de la dentina seca con un sistema adhesivo multimodo puede ser superior a la dentina húmeda con aplicación sónica. Los modos de aplicación no tuvieron influencia en la resistencia de la unión de los adhesivos estudiados.

Effects of thermal cycling on bonding properties of novel low-shrinkage resin adhesive / 华西口腔医学杂志

OBJECTIVES@#The current study aimed to investigate the bonding properties of a novel low-shrinkage resin adhesive containing expanding monomer and epoxy resin monomer after thermal cycling aging treatment.@*METHODS@#Expanding monomer of 3,9-diethyl-3,9-dimethylol-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) as an anti-shrinkage additive and unsaturated epoxy monomer of diallyl bisphenol A diglycidyl ether (DBDE) as a coupling agent were synthesized. A blend of DDTU and DBDE at a mass ratio of 1∶1, referred to as "UE", was added into the resin matrix at the mass fraction of 20% to prepare a novel low-shrinkage resin adhesive.Then, the methacrylate resin adhesive without UE was used as the blank control group, and a commercial resin adhesive system was selected as the commercial control group. Moreover, the resin-dentin bonding and micro-leakage testing specimens were prepared for the thermal cycling aging treatment. The bonding strength was tested, the fracture modes were calculated, the bonding fracture surface was observed by scanning electron microscope (SEM), and the dye penetration was used to evaluate the tooth-restoration marginal interface micro-leakage. All the data were analyzed statistically.@*RESULTS@#After aging, the dentin bonding strength of the experimental group was (19.20±1.03) MPa without a significant decrease (P>0.05), that of the blank control group was (11.22±1.48) MPa with a significant decrease (P<0.05) and that of the commercial control group was (19.16±1.68) MPa without a significant decrease (P>0.05). The interface fracture was observed as the main fracture mode in each group after thermal cycling by SEM. The fractured bonding surfaces of the experimental group often occurred on the top of the hybrid layer, whereas those of the blank and commercial control groups mostly occurred on the bottom of the hybrid layer. Micro-leakage rating counts of specimens before and after thermal cycling were as follows: the experimental group was primarily 0 grade, thereby indicating that a relatively ideal marginal sealing effect could be achieved (P>0.05); meanwhile, the blank control group was primarily 1 grade, and the penetration depth of dye significantly increased after thermal cycling (P<0.05); the commercial control group was primarily 0 grade without statistical difference before and after thermal cycling (P>0.05), while a significant difference was observed between the commercial control group and experimental group after thermal cycling (P<0.05).@*CONCLUSIONS@#The novel low-shrinkage resin adhesive containing 20%UE exhibited excellent bonding properties even after thermal cycling aging treatment, thereby showing a promising prospect for dental application.

Applications of collagen extrafibrillar demineralization in dentin bonding / 中华口腔医学杂志

The existing dentin bonding systems based on acid-etching technique lead to the loss of both extrafibrillar and intrafibrillar minerals from dentin collagen, causing excessive demineralization. Because resin monomers can not infiltrate the intrafibrillar spaces of demineralized collagen matrix, degradation of exposed collagen and resin hydrolysis subsequently occur within the hybrid layer, which seriously jeopardizing the longevity of resin-dentin bonding. Collagen extrafibrillar demineralization can effectively avoid the structural defects within the resin-dentin interface caused by acid-etching technique and improve the durability of resin-dentin bonding, by preserving intrafibrillar minerals and selectively demineralizing extrafibrillar dentin. The mechanism and research progress of collagen extrafibrillar demineralization in dentin bonding are reviewed in the paper.

Effect of time and dental substrate on the bond strength of a universal adhesive system: in vitro study / Efeito do tempo e do substrato dental na resistência de união de um sistema adesivo universal: estudo in vitro

Introduction: Dentin adhesives provide union between the dental substrate and composite resin, but this union can be influenced by the cleaning agent. Objective: Evaluate the use of ozonated water as a cavity cleaning solution. Material and method: 40 bovine dental crowns were selected, divided into four groups: AD (dentin cleaning with distilled water) and AO (dentin cleaning with ozonized distilled water). Each group was divided into two storage periods (24h and 30 days) kept at 37 °C. The selected universal system adhesive was employed according to the manufacturer's instructions and light cured for 20 seconds. At that time, three cylinders were made (Tygon matrix with an internal diameter of 2 mm and a height of 2 mm) of composite resin in the crowns in the cervical, médium, and incisal regions and light cured for 30 seconds. After storage, the bonding strength was tested by micro-shear, and fracture type analysis was performed. The data were submitted to statistical analysis using the Shapiro-Wilk test with a significance level of 95%, ANOVA, and Turkey. Result: There was a statistically significant difference between the bond strength values, only in the intergroup analysis for the time of 24 hours, between the middle third of the groups (LDAO24 = 2.70 (± 2.39); LDAO30 = 3.82 (± 2.31)). The predominant fracture type for both groups was an adhesive fracture, except in the medium and incisal thirds of the AD, which was a cohesive dentin fracture. Conclusion: The utilization of ozone did not change the bond strength adhesive.

Introdução: Os adesivos dentinários proporcionam união entre o substrato dental e resina composta, porém esta união pode ser influenciada pelo agente de limpeza. Objetivo: Avaliar a influência na resistência de união (RU) de um sistema adesivo universal associado à da água ozonizada como solução de limpeza cavitária. Material e método: Foram selecionadas 40 coroas de dentes anteriores bovinos divididos em 4 grupos: AD (limpeza dentinária com água destilada) e AO (limpeza dentinária com água destilada ozonizada). Cada grupo foi subdividido em outros dois grupos de acordo com o tempo de armazenamento (24h e 30 dias) armazenados a 37ºC. A limpeza dentinária foi realizada por meio de uma seringa de 60mL de cada solução e fricção por 10 segundos. O sistema adesivo universal selecionado foi aplicado de acordo com as instruções do fabricante e fotoativado por 20 segundos. Em seguida, foram confeccionados 3 cilindros (matriz Tygon com um diâmetro interno de 2 mm e 2 mm de altura) de resina composta nas coroas nas regiões cervical, média e incisal e fotoativados por 30 segundos. Após o armazenamento foi realizado o teste de RU por microcisalhamento e análise do tipo de fratura. Os dados coletados foram submetidos a análise estatística através do teste de Shapiro Wilk com nível de significância de 95%, ANOVA e Tukey. Resultado: Houve diferença estatística significativa entre os valores de RU apenas na análise intergrupos para o tempo de 24 horas, entre o terço médio dos grupos (LDAO24 = 2,70 (± 2,39); LDAO30 = 3,82 (± 2,31)). O tipo de fratura predominante para ambos os grupos em todos os tempos foi de fratura adesiva, com exceção ao terço médio e incisal do AD, que foi fratura coesiva de dentina. Conclusão: A utilização do ozônio não alterou a resistência de união adesiva.

Influence of two natural cross-linkers on microtensile bond strength durability ­ An in vitro study / Influência de dois reticuladores naturais na durabilidade da resistência de união à microtração ­ Um estudo in vitro

Objective: to investigate the effect of two natural cross-linkers on microtensile bond strength (µTBS) and evaluate their influence on the durability of the resin dentin bonds. Material and Methods: the Moringa oleifera and Centella asiatica plant extracts were qualitatively tested with high-performance thin layer chromatography (HPTLC) for the presence of phenols. The phenolic content ranged from 27 to 30 gallic acid equivalents (GAE), µg/mg of dry weight. After etching, two concentrations (5% and 1%) of these two extracts were prepared and used as pretreatment liners on dentin. They were applied for a min. After restoration with resin composite, dentin resin beams were prepared. The study groups were 5% Moringa, 1% Moringa 5% Centella 1% Centella, and control (without cross-linker application). For each group, half of the samples underwent µTBS testing after 24 hours, while the remaining half were immersed in artificial saliva to assess the bond's longevity after 6 months of ageing. Statistical analysis was performed using one-way ANOVA followed by Tukey's post hoc test. Results: both 5% and 1% Moringa showed a significant difference (p<0.05) compared to the other groups at both intervals. However, after ageing, the specimens in the control and 1% Centella groups resulted in a significant decrease in µTBS. Conclusion: overall, both concentrations of Moringa (5% and 1%) were effective in stabilising the bond during both intervals.(AU)

Objetivo: investigar o efeito de dois reticuladores naturais na resistência de união (µTBS) à microtração e avaliar sua influência na durabilidade da adesão da resina à dentina. Material e Métodos: extratos das plantas Moringa oleifera e Centella asiatica foram qualitativamente testados através de cromatografia em camada fina de alta performance (HPTLC) para a presença de fenóis. O conteúdo fenólico alcançou entre 27 a 30 equivalentes de ácido gálico (GAE), µg/mg de peso seco. Após o condicionamento, duas concentrações (5% e 1%) dos extratos foram preparadas e utilizadas como forros de pré-tratamento em dentina. Eles foram aplicados por um minuto. Após a restauração com resina composta, palitos de dentina e resina foram preparados. Os grupos foram 5% Moringa, 1% Moringa, 5% Centella, 1% Centella e controle (sem aplicação de reticulador). Para cada grupo, metade das amostras foram submetidas ao teste µTBS após 24 horas, enquanto a outra metade foi imersa em saliva artificial para avaliar a longevidade adesiva após 6 meses de envelhecimento. Foi realizada análise estatística através de ANOVA 1-fator, seguido do teste post hoc de Tukey. Resultados: ambas as concentrações de 5% e 1% de Moringa demonstraram diferença significativa (p<0.05) comparadas aos outros grupos em ambos os intervalos. No entanto, após o envelhecimento, os espécimes dos geupos controle e 1% de Centella resultaram em uma redução significativa de µTBS. Conclusão: no geral, ambas as concentrações de Moringa (5% e 1%) foram efetivas em estabelecer a adesão em ambos os intervalos (AU)

Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review

ABSTRACT Objective: To find out what the acid-base resistant zone (ABRZ) is and the mechanism of its formation. Material and Methods: This systematic review was based on the search of laboratory studies in which selfetching adhesive systems were used. The electronic database PubMed was used for the search. The search began on August 2021 and ended on June 2022. We have analyzed the materials and methods of each research and entered them in the appropriate tables to give a clearer assessment of the obtained results. Results: This systematic review included 15 full-text articles published from 2011 to 2019. The ABRZ is formed on both dentine and enamel. On dentine, the ABRZ is formed only when using self-etching adhesive systems; on the enamel, on the contrary, the step of preliminary etch and rinse contributes to the formation of a thicker ABRZ. The functional monomer MDP and fluorine increase the thickness of the ABRZ and provide a hybrid layer /ABRZ boundary without defects and erosions. Conclusion: Self-etching adhesive systems ensure the creation of an ABRZ resistant to acid-base tests. This phenomenon can provide the resistance of tooth tissues to demineralization, and therefore increase their resistance to caries.

Mineral Density Distribution Differences in Enamel and Dentin Tissues in the Teeth Array According to the HU Scale

ABSTRACT Objective: To evaluate the mineral density of enamel and dentin tissues of healthy individuals using threedimensional cone-beam computed tomography. Material and Methods: CBCT images of 15 healthy individuals, previously obtained for various reasons, were used in this study. In HU measurements, mineral density measurements were made from three different regions of enamel and three different regions of dentin, and the values obtained were compared. Enamel and dentin mineralization density measurements were measured from six regions, namely the crown cutting edge, buccal middle and cervical region for enamel, and the crown cutting edge, cervical region and root apex for dentin. In the comparisons of groups, the parametric One-Way ANOVA variance analysis method was applied. In the paired comparisons between the groups, the Tukey HSD test was applied as the multiple comparison post hoc test. A value of p<0.05 was accepted as statistically significant. Results: Mineralization density of tooth enamel and dentin tissues was quantitatively different in the maxilla and mandible in anterior and posterior teeth. Conclusion: In all the teeth, there were statistically significant decreases in the mineral density values of enamel and dentin tissue from occlusal towards the cemento-enamel junction. Statistically significant decreases were observed in the mineral density values of enamel and dentin tissue from the anterior region towards the posterior region in the teeth in both the upper and lower jaws.

Effect of adhesive primer application on shear bond strength of self-adhesive cement to tooth structure and two different CAD/CAM milled blocks / Efeito da aplicação do primer adesivo na resistência ao cisalhamento do cimento autoadesivo à estrutura dentária e a dois diferentes blocos fresados CAD/CAM

Objective: This study was conducted to evaluate the influence of the G-CEM ONE adhesive enhancing primer on the shear bond strength of self-adhesive resin cement (G-CEM ONE) to both tooth structure and two different CAD/CAM blocks (GC Initial LiSi and Cerasmart 270). Material and Methods: Forty specimens (cylindrical-shaped, 5 mm in diameter and height) were milled from both CAD/CAM blocks (20 specimens from each block type). Forty sound upper premolars were sectioned to the level of peripheral dentin, then randomly divided into four groups (n = 10): A1: GC Initial LiSi without adhesive enhancing primer; B1: Cerasmart 270 without adhesive enhancing primer; A2: GC Initial LiSi with adhesive enhancing primer; B2: Cerasmart 270 group with adhesive enhancing primer application. The CAD/CAM blocks were cemented on teeth using a self-adhesive resin cement (G-cem one). The shear bond strength was assessed using a computerized universal testing machine. A digital microscope was used to study the mode of failure. The shear bond strength values data were analyzed statistically using paired t-test and independent t-test at the significance level of (0.05). Results: A significant difference was shown in the shear bond strength values among groups (P =0.000). The highest shear bond strength value was revealed in group A2, while group B1 exhibited the lowest shear bond strength value. Conclusion: Using the adhesive enhancing primer on the tooth's surface improved the resin cement's bond strength to CAD/CAM blocks. Additionally, GC Initial LiSi exhibited higher bond strength than Cerasmart 270, with or without the primer (AU)

Objetivo: Este estudo foi conduzido para avaliar a influência do primer adesivo G-CEM ONE na resistência ao cisalhamento do cimento resinoso autoadesivo (G-CEM ONE) tanto na estrutura dentária quanto em dois diferentes blocos CAD/CAM (GC Initial LiSi e Cerasmart 270). Material e Métodos: Quarenta corpos de prova (formato cilíndrico, 5 mm de diâmetro e altura) foram fresados em blocos CAD/CAM (20 corpos de prova de cada tipo de bloco). Quarenta pré-molares superiores sadios foram seccionados até o nível da dentina mais externa e, em seguida, divididos aleatoriamente em quatro grupos (n = 10): A1: GC Initial LiSi sem primer adesivo; B1: Cerasmart 270 sem primer adesivo; A2: GC Initial LiSi com primer adesivo; B2: Grupo Cerasmart 270 com aplicação de primer adesivo. Os blocos CAD/CAM foram cimentados nos dentes com cimento resinoso autoadesivo (G-CEM ONE). A resistência ao cisalhamento foi avaliada utilizando uma máquina de ensaios universal computadorizada. Um microscópio digital foi utilizado para estudar o modo de falha. Os dados dos valores de resistência ao cisalhamento foram analisados estatisticamente por meio do teste t pareado e teste t independente ao nível de significância de (0,05). Resultados: Foi demonstrada diferença significativa nos valores de resistência ao cisalhamento entre os grupos (P =0,000). O maior valor de resistência ao cisalhamento foi revelado no grupo A2, enquanto o grupo B1 exibiu o menor valor de resistência ao cisalhamento. Conclusão:A utilização do primer adesivo na superfície dentária melhorou a resistência de união do cimento resinoso aos blocos CAD/CAM. Além disso, o GC Initial LiSi apresentou maior resistência de união que o Cerasmart 270, com ou sem primer.(AU)

Dentin permeability after pretreatment with titanium tetrafluoride and self-etching or universal adhesive systems

Aim: To evaluate dentin permeability after pretreatment with 2.5% aqueous solution of titanium tetrafluoride (TiF4), followed by a self-etching universal adhesive system. Methods: Forty dentin discs (1.5 mm thick) were randomly divided into groups according to the application or non-application of a pretreatment, and the type of adhesive system to be tested (two-step self-etching/ Clearfil SE Bond/ Kuraray Medical, or universal adhesive system/ Single Bond Universal/ 3M ESPE). Both sides of the discs were conditioned with 37% phosphoric acid to remove the smear layer. The first hydraulic conductivity measurement (L1) was performed in a permeability machine, under 5 PSI pressure. The samples were sanded again to form a standardized smear layer. The teeth designated for pre-treatment with TiF4 received the TiF4 solutions applied actively for 60 seconds, and the adhesive systems were applied according to the manufacturer's instructions. Then, a new hydraulic conductivity measurement (L2) was performed for the purpose of calculating the hydraulic conductance at a later time, considering the water viscosity and the thickness of the specimen. The percentage (L) of dentin permeability after application of the adhesive system was obtained (L (%) = [(L1-L2) x100] / L1). The Mann-Whitney non-parametric test was applied. Results: There was no difference between the two adhesive systems, or between the groups with or without pretreatment, as regards dentin permeability (p>0.05). Conclusion: Pretreatment with 2.5% TiF4 did not influence dentin permeability, irrespective of the adhesive system used

Impact of photoinitiator quality on chemical-mechanical properties of dental adhesives under different light intensities / Impacto da qualidade de fotoiniciadores nas propriedades químico mecânicas de adesivos dentais sob diferentes intensidades de luz

Objective: Evaluate the mechanical properties of experimental adhesive models with different photoinitiators (PI) polymerized by LED units of different power densities. Material and Methods: Three groups of adhesive models based on HEMA/BisGMA (45/55) were prepared in association with different PI combinations: G2 (control) ­ 2 PI: 0.5% CQ, 0.5% EDMAB; G3 - 3 PI: 0.5% CQ; 0.5% DMAEMA, 0.5% DPIHP; G4 - 4 PI: 0.5% CQ; 0.5% EDMAB; 0.5% DMAEMA; 0.5% DPIHP. The three formulations were polymerized at two different LED power densities: 550 mW/cm2 and 1200 mW/cm2. The degree of conversion (DC) of adhesive monomers was monitored in situ through the FTIR for 600 s. Specimens were prepared for each formulation for analysis mong adhesive systems (G2

Objetivo: Avaliar as propriedades mecânicas de modelos adesivos experimentais com diferentes fotoiniciadores (PI) polimerizados por unidades de LED de diferentes densidades de energia. Material e Métodos: Três grupos de modelos adesivos baseados em HEMA/BisGMA (45/55) foram preparados em associação com diferentes combinações de PI: G2 (controle) ­ 2 PI: 0,5% CQ, 0,5% EDMAB; G3 - 3PI: 0,5% CQ; 0,5% DMAEMA, 0,5% DPIHP; G4 - 4 PI: 0,5% CQ; 0,5% EDMAB; 0,5% DMAEMA; 0,5% DPIHP. As três formulações foram polimerizadas em duas densidades de potência de LED: 550 mW/cm2 e 1200 mW/cm2. O grau de conversão (DC) dos monômeros adesivos foi monitorado in situ através do FTIR durante 600 s. Amostras foram preparadas para cada formulação para análise de resistência à flexão (FS), módulo de elasticidade (ME), sorção (SOR) e solubilidade (SOL). Os dados foram submetidos aos testes ANOVA 2-fatores e Tukey (5%). Resultados: DC: houve diferença significativa entre os sistemas adesivos (G2

Influence of chlorhexidine 2% and sodium hypochlorite 5. 25% on micro-tensile bond strength of Universal adhesive system (G-Premio Bond)

Aim One of the reasons for the failure of adhesion in composite restorations and secondary caries may be the chemical irrigants used during the endodontic treatment. NaOCl is widely used for the biomechanical preparation of root canals due to its antimicrobial properties and capacity to dissolve organic material. In addition, another very effective decontamination solution is chlorhexidine 2%. There are few studies about the effect of root canal irrigation solutions on bond strength of universal adhesives therefore, in this study we have investigated the influence of CHX 2% and NaOCl 5.25% on micro-tensile bond strength of G-Premio Bond. Methods Twenty-four human teeth were randomly allocated to the following groups: G1, immersion in saline solution 0.9% for 30 minutes (control); G2, immersion in CHX 2% for 30 minutes; G3, immersion in NaOCl 5.25% for 30 minutes. After restoration, the dentin/resin interface was tested by micro-tensile bond strength. The surfaces morphology was analyzed by Scanning Electron Microscopy. Data were analyzed by ANOVA followed by Tukey test in SPSS software Version 24. Results There was a statistically significant difference between G3 and G1 (P < 0.05). There were no statistically significant differences among G1 and G2, G2 and G3. Conclusion Root canal irrigation with NaOCl 5.25% significantly reduced the micro-tensile bond strength in the G-Premio Bond at self-etch mode, but the use of CHX did not make a significant difference.

Uso de adhesivo universal con pregrabado y autograbado en tejidos duros del diente / Use of universal adhesive with pre-etch and self etch strategies on hard tooth tissues

RESUMEN Introducción: Buscando satisfacer la demanda con procedimientos adhesivos más rápidos, menos sensibles a la técnica y facilidad de uso, se han desarrollado los adhesivos universales, que brindan al profesional la opción de seleccionar la estrategia de adhesión con diferentes modos de grabado, ya sea con grabado y enjuague, autograbado o grabado selectivo. Debido a la poca información existente, se han generado dudas sobre el rendimiento, propiedades y la aplicación de una técnica adhesiva adecuada sobre los tejidos dentales. Objetivo: Determinar el nivel de adhesión con el uso de adhesivos universales en modo de grabado y enjuague y autograbado. Métodos: Se realizó una revisión de la literatura, a través de la búsqueda electrónica en las bases de datos: SciELO, Scopus, PubMed, Springer y EBSCO. Inicialmente se seleccionaron por título y resumen, artículos duplicados se consideraron solo una vez, se incluyeron artículos de acceso libre y pagos, escritos en idioma español e inglés, publicados desde el año 2015, de los cuales 39 artículos fueron seleccionados para el estudio. Conclusiones: El uso de adhesivos universales sobre dentina presenta un nivel de adhesión mayor cuando se aplica en modo de autograbado. La aplicación activa del adhesivo universal en esmalte mejora la fuerza y resistencia de unión. El nivel de adhesión en el esmalte es mayor cuando se aplica en modo de grabado y enjuague. La resistencia inicial y por fatiga del adhesivo, no mejora con los tiempos prolongados del grabado ácido.

ABSTRACT Introduction: universal adhesives have been developed to satisfy the demand with faster adhesive procedures, less sensitive to the technique and ease of use, which offer the professional the option of selecting the adhesion strategy with different etching modes, either with etch-and-rinse, self-etch or selective etching ones. Doubts have been generated about the performance, properties and application of an adequate adhesive technique on dental tissues due to the little existing information. Objective: to determine the level of adhesion with the use of universal adhesives in etch-and-rinse and self-etch modes Methods: an electronic search of the literature was carried out in SciELO, Scopus, PubMed, Springer and EBSCO databases. Initially, articles were selected by title and abstract, duplicate ones were considered only once, free and paid access articles, written in Spanish and English and published since 2015 were included; 39 of them were selected for the study. Conclusions: the use of universal adhesives on dentin presents a higher level of adhesion when applied in self-etch mode. The active application of the universal adhesive improves the enamel bond strength. The level of adhesion on the enamel is higher when applied in etch-and-rinse. The initial fatigue resistance of the adhesive does not improve with prolonged acid etching times.

Dual-cured adhesive system improves adhesive properties of dentin cavities restored with a bulk-fill resin composite

Aim: To evaluate the impact of a dual-cured adhesive system on the in situ degree of conversion (DC), bond strength (BS) and failure mode (FM) of adhesive interfaces in dentin cavities restored with a bulk-fill resin composite. Methods: 4-mm-deep dentin cavities with a 3.1 C-factor were created in 68 bovine incisors (n = 17 per group). The lightcured (Scotchbond™ Universal) or the dual-cured (Adper™ Scotchbond™ Multi-purpose Plus) adhesive system was applied to the cavities, which were then restored with a bulkfill resin composite (Filtek™ Bulk Fill). In situ DC analysis was performed by means of micro Raman spectroscopy at the top and bottom interfaces. Push-out BS was measured in a universal testing machine after 24-h or 6-month water storage. FM was determined with a stereomicroscope. Data of in situ DC and BS were analyzed by two-way analysis of variance (ANOVA) and Tukey test (p<0.05), while the FM was analyzed descriptively. Results: The groups that received the dual-cured adhesive system showed statistically higher in situ DC and BS than those that received the light-cured adhesive system. Cohesive failure mode was the most frequent in all conditions. Conclusion: In situ DC and BS were influenced by the curing strategies of the adhesive systems with better performance of the dual-cured material

Influence of etching Mode and composite type on bond strength to biodentine using a ''No-Wait'' universal adhesive / Influencia del modo de grabado y del tipo de resina en la resistencia adhesiva al Biodentine utilizando un adhesivo universal tipo "no-wait"

Abstract: The purpose of this study was to compare the shear bond strength (SBS) of four resin-based composite materials to a silicate-based cement using a ''no-wait'' universal bond with self-etch (SE) and etch-and-rinse (ER) modes. Acrylic blocks (n=80, 2mm depth, 5mm diameter central hole) were prepared. The holes were filled with BiodentineTM (BD) and divided into 4 main groups (n=20) according to the composite resin type used: Group FZ250: FiltekTM Z250 Universal Restorative (microhybrid), Group SDR: SDR Plus U Bulk Fill Flowable (low-viscosity bulk-fill), Group FBP: FiltekTM Bulk Fill Posterior (high-viscosity bulk-fill), Group EF: EsFlow™ Universal Flowable Composite (nanohybrid). A 'no-wait' universal bond (Clearfil Universal Bond Quick) was used for bonding application. Then each group was divided into 2 subgroups according to the etching mode applied (ER and SE). SBSs were measured and stereomicroscope was used to identify the failure modes. Selected samples of fracture surfaces were imaged by SEM. Tukey's post-hoc and One-way ANOVA tests were used to analyze data. There were statistically significant differences among the composite groups (p 0.05). The SBS of BD to the resin composites depends on the composite type but application of the 'no-wait' universal bond in different etching modes is regardless of the SBS of BD to resin composites.

Resumen El objetivo de este estudio fue comparar la resistencia de adhesión al cizallamiento (SBS) de cuatro resinas con un cemento a base de silicato utilizando una adhesivo universal "no-wait" de autograbado (SE) y grabado y lavado (ER). Se prepararon bloques acrílicos (n=80, de 2mm de profundidad y un agujero central de 5mm de diámetro). Los agujeros se rellenaron con BiodentineTM (BD) y se dividieron en 4 grupos principales (n=20) según el tipo de resina compuesta utilizada: Grupo FZ250: FiltekTM Z250 Universal Restorative (microhíbrido), Grupo SDR: SDR Plus U Bulk Fill Flowable (bulk-fill de baja viscosidad), Grupo FBP: FiltekTM Bulk Fill Posterior (bulk-fill de alta viscosidad), Grupo EF: EsFlow™ Universal Flowable Composite (nanohíbrido). Para la aplicación de la adhesión se utilizó un adhesivo universal "no-wait" (Clearfil Universal Bond Quick). A continuación, cada grupo se dividió en 2 subgrupos según el modo de grabado aplicado (ER y SE). Se midieron los SBS y se utilizó el estereomicroscopio para identificar los modos de fallo. Las muestras seleccionadas de las superficies de fractura se analizaron mediante SEM. Se utilizaron las pruebas post-hoc de Tukey y ANOVA de una vía para analizar los datos. Hubo diferencias estadísticamente significativas entre los grupos de composites (p0,05). La SBS de la BD a los composites de resina depende del tipo de composite, pero la aplicación de la unión universal "no-wait" en los diferentes modos de grabado es independiente de la SBS de la BD a los composites de resina.

Evaluation of dentin microroughness and composite bond strength after multiple uses of diamond burs / Evaluación de la micro rugosidad dentinaria y la resistencia adhesiva de composites tras múltiples usos de fresas de diamante

Abstract Using a bur multiple times to prepare dental structure may produce a smoother final surface on dentin than a new one. This superficial roughness may affect adhesion with resin-based materials by modifying the substrates' characteristics. The aim of this study was to evaluate the effect of multiple uses of diamond burs on dentin's superficial microroughness and bond strength with resin composite when using a self-etch adhesive. Diamond dental burs were used to simulate a preparation (dentin flat surface) on extracted third molars. Samples were distributed into groups according to burs' number of previous uses as follows: 0, 1, 5 and 10. Scanning electron microscopy images at 70x, 350x, and 1000x were used to illustrate burs' deformation. Each specimen's dentin microroughness was measured three times to compare between experimental groups and the micro-shear bond strength test (n=15) was performed for the 0 and 10 uses groups using a universal adhesive in a self- etching mode. Diamond crystals wear and dislodgements were evident among groups where the burs were used more times. As the number of uses increased the mean microroughness of the dentin surface decreased with significant differences between the 0 and 10 uses groups. No statistical differences between experimental groups resulted from bond strength tests. When using a universal adhesive in a self-etching mode, the number of previous uses of a diamond bur seems to have no significant effect on dentin/resin composite bond strength.

Resumen El uso de una fresa múltiples veces para preparar la estructura dental puede producir una superficie final más lisa en la dentina que una fresa nueva. Esta rugosidad superficial modifica las características del sustrato y puede afectar la adhesión con materiales resinosos. El objetivo de este estudio fue evaluar el efecto de los múltiples usos de las fresas de diamante sobre la micro rugosidad superficial de la dentina y la resistencia adhesiva con la resina compuesta cuando se utiliza un adhesivo de autograbado. Se utilizaron fresas dentales de diamante para simular una preparación (superficie plana de la dentina) en terceros molares extraídos. Las muestras se distribuyeron en grupos según el número de usos previos de las fresas de la siguiente manera: 0, 1, 5 y 10. Se utilizaron imágenes de microscopía electrónica de barrido a ×70, ×350 y ×1000 para ilustrar la deformación de las fresas. Se midió la micro rugosidad de la dentina de cada espécimen tres veces para comparar entre los grupos experimentales y se realizó la prueba de resistencia a la adhesión por micro cizallamiento (n=15) para los grupos de 0 y 10 usos utilizando un adhesivo universal en modo de autograbado. El desgaste de los cristales de diamante y los desprendimientos fueron evidentes entre los grupos en los que las fresas se utilizaron más veces. A medida que aumentaba el número de usos, la micro rugosidad media de la superficie de la dentina disminuyó, con diferencias significativas entre los grupos de 0 y 10 usos. En las pruebas de resistencia adhesiva no se observaron diferencias estadísticas entre los grupos experimentales. Cuando se utiliza un adhesivo universal en modo de autograbado, el número de usos previos de una fresa de diamante no parece tener un efecto significativo en la resistencia de la unión dentina/resina del composite.