ABSTRACT
Abstract: To evaluate the effect of selective or nonselective carious tissue removal and the use of a resin-modified glass ionomer (RMGIC) liner under bulk fill resin composite restoration on the stress at the pulp chamber, the elastic moduli of hard, firm, soft and intact dentin were calculated using nanoindentation. Post-gel shrinkage of the bulk fill resin composite and RMGIC were determined using the strain-gauge method. Six finite element models were created by using digital radiography with the combination of two study factors: a) carious tissue removal: selective removal or nonselective removal of carious tissue, and b) use of RMGIC liner: with or without 1.0 mm of RMGIC liner. The modified von Mises stresses (mvm) (MPa) were extracted on the nodes of the internal wall of the pulp ceiling chamber at 100 N occlusal loading. Data were analyzed descriptively and recorded quantitively. Both study factors influenced the stress distribution. The mvm stress during the restorative procedure was higher for nonselective carious tissue removal without RMGIC (25.9 MPa) and lower for selective carious tissue removal associated with RMGIC (13.5 MPa). The dentin elastic modulus increased from soft carious (3.6 ± 0.3 MPa) to firm carious (5.2 ± 1.0 MPa) to hard carious (10.9 ± 1.2 MPa) to intact dentin (22.7 ± 3.0 MPa). Molars with carious lesions showed high mvm stress at the pulp ceiling (89.6 MPa) and at fragilized coronal structure remaining. Selective carious tissue removal followed by restoration using a Vitrebond liner and Tetric N-Ceram Bulk fill reduced the stress at the pulp chamber ceiling.
ABSTRACT
Abstract The combination of the restoration location, the hand preference of the operator using the light-curing unit (LCU), and the design of the LCU all can have an impact on the amount of the light delivered to the restoration. To evaluate the effect of left-handed or right-handed users, the position of the operator (dentist or assistant), and the LCU design on the irradiance, radiant exposure and emission spectrum delivered to the same posterior tooth. Two light emitting diode (LED) LCUs were tested: an angulated monowave LCU Radii-Cal (SDI, Victoria, Australia) and a straight aligned multi-peak LCU Valo Cordless (Ultradent, South Jordan, UT, USA). The irradiance values (mW/cm2), radiant exposure (J/cm2) and emission spectrum were measured using a sensor in maxillary left second molar tooth. The irradiance and radiant exposure were analyzed using three-way ANOVA followed by Tukey test (a=0.05). The emission spectra (nm) were analyzed descriptively. The interaction between LCU design, operator position, and hand preference significantly influenced the irradiance and radiant exposure (P<0.001). In all cases, Valo delivered significantly higher irradiance than Radii-Cal. The handedness and the operator position affected the irradiance and radiant exposure delivered from Valo. Operator position and access affect the irradiance and radiant exposure delivered to the maxillary left second molar. The irradiance and radiant exposure can be greater when a right-hand operator is positioned on the right side of the chair and a left-hand operator is positioned on the left side of the chair. This may result in better resin composite polymerization.
Resumo A combinação da localização da restauração, a preferência de mão do operador ao utilizar aparelhos fotopolimerizadores (AFP) com luz emitida por diodo (LED) e o formato do AFP podem afetar a quantidade de luz fornecida à restauração. O objetivo foi avaliar o efeito de operadores canhotos e destros, a posição do operador (dentista ou auxiliar), e o formato do AFP na irradiância, energia radiante e espectro de luz entregue ao mesmo dente posterior. Dois AFP foram testados: um com formato angulado, onda única Radii-Cal (SDI, Victoria, Australia) e um formato reto multi-pico Valo Cordless (Ultradent, South Jordan, UT, USA). Os valores de irradiância (mW/cm²), energia radiante (J/cm²) e espectro de luz foram medidos utilizando um sensor no segundo molar superior esquerdo. A irradiância e energia radiante foram analisados utilizando ANOVA 3 fatores seguido por teste de Tukey (a=0.05). O espectro de luz (nm) foi analisado de forma descritiva. A interação entre o formato do AFP, posição do operador e preferência de mão foram significativamente influentes na irradiância e energia radiante (P<0.001). Em todos os casos, Valo teve irradiância significativamente maior que Radii-Cal. A mão dominante e a posição do operador afetaram a irradiância e energia radiante com o Valo. Posição do operador e acesso afetou a irradiância e exposição radiante entregue ao segundo molar superior esquerdo. A irradiância e exposição radiante teve melhores resultados quando AFP foi utilizado com a mão direita pelo operador posicionado na cadeira do lado direito e mão esquerda do operador posicionado do lado esquerdo da cadeira. Estes resultados podem levar a uma melhor polimerização da resina composta.
Subject(s)
Humans , Radiation Exposure , Dental Assistants , Curing Lights, Dental , Functional Laterality , Light , Equipment DesignABSTRACT
A busca pela estética tem acentuado a procura dos pacientes pela transformação do sorriso. Com o auxílio da fotografia e da tecnologia computacional, é possível a realização do DSD (digital smile design planejamento digital do sorriso), que nos dá maior previsibilidade do tratamento. A confirmação deste planejamento digital se dá na prova do mock-up, a partir do qual o paciente tem a real sensação do seu sorriso planejado. Este artigo apresentou um caso clínico no qual se destaca a adesão do paciente ao tratamento e a realização de cirurgia periodontal para aumento de coroa clínica, seguida de restaurações diretas com resinas compostas, posterior ao enceramento diagnóstico. Com o planejamento integrando a terapia cirúrgica periodontal e o protocolo restaurador adesivo direto guiado por planejamento digital (DSD), foi possível estabelecer um excelente resultado com uma elevada satisfação do paciente.
The seek for esthetics has increased patient´s demand for the smile makeover. With the help of computational technology, it is possible to perform the DSD (digital smile design) with greater treatment predictability treatment. Confirmation of this digital planning occurs in the mock-up test, from which the patient has a physical sensation of his/her planned smile. This article presents a clinical case which highlights the patient cooperation and periodontal surgery for crown lengthening, followed by direct composite resin restorations after the diagnostic wax-up procedure. With an integrated treatment planning guided by the DSD protocol, it was possible to establish an excellent outcome with high patient satisfaction.