A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Bond strength of bulk-fill resin composites: the effect of cavity preparation and aging

Aim: Evaluating the resin-dentin bond strength of Class II conventional and bulk-fill composite restorations, using different cavity sizes before and after aging. Methods: Seventy-five human molars were distributed into groups according to the buccolingual width of the cavities, conservative (n=25) and extended (n=50). They were divided according to the restorative material: conventional (Z100/control group) or bulk-fill resin composites (Filtek Bulk Fill/FBF; Tetric N Ceram Bulk Fill/TNCBF; Filtek Bulk Fill Flow/FBFF; Surefill SDR flow/SDR). The restored teeth were sectioned on sticks (n=50 per restorative materials + width cavities group), half were stored in Water/Ethanol 75% for 30 days and the other half were submitted to the immediate microtensile bond strength (µTBS) test. Data were analyzed applying the Three-Way Analysis of Variance (ANOVA), Bonferroni test, test t, and Weibull analyses (p<0.05). Results: SDR and FBF presented lower µTBSvalues for extended preparation when compared to the conservative preparation, before aging. After aging, only for the FBFF, a decrease in the µTBSvalues was observed. Comparing the µTBSvalues, before and after aging, the SDR demonstrated lower µTBSvalues after aging when the conservative cavity was used. A decrease in the µTBSvalues was observed for the Z100, the FBF and, the FBFF, after aging, when the extended cavity was used. Conclusion: The effect of cavity preparation and aging on the resin-dentin of Class II is material dependent. Most of the bulk-fill resin composites evaluated presented a similar performance to the conventional resin composites for all the conditions of this study

Biomechanical, operative and biological aspects of the cervical margin relocation: a case report / Aspectos biomecânicos, operatórios e biológicos da recolocação da margem cervical com resina composta em cavidades classe II com margens profundas: um relato de caso

The clinical success of tooth-colored indirect restorations has been confirmed in several studies. However, inlays and onlays restorations in Class II cavities with deep gingival margins can still be considered a clinical challenge. With the purpose of facilitating the execution of the operative procedures in intrasulcular margins and reducing the risk of restorative failures, the technique of cervical margin relocation has been explored as a noninvasive alternative to surgical crown lengthening. This work aims at discussing through a case report the biomechanical, operative and biological aspects in the treatment of teeth with deep gingival margins. Therefore, given the therapy applied in the clinical case presented, it is concluded that the cervical margin relocation with composite resin is advantageous since it eliminates the need for surgery, allowing the implementation of indirect restorations in fewer clinical sessions, not causing damage to periodontal tissues once it provided good finishing and polishing with the establishment of a correct emergence profile, allowing flawless maintenance of gingival health after one year. (AU)

Sucesso clínico das restaurações indiretas livres de metal tem sido confirmado em diversos estudos. No entanto, restaurações parciais indiretas em cavidades do tipo classe II com margens profundas ainda podem ser consideradas um desafio clínico. Com a proposta de facilitar a execução dos procedimentos operatórios em margens intra-sulculares e reduzir a ocorrência de falhas, a técnica de elevação da margem gengival em resina composta tem sido explorada como alternativa não invasiva à cirurgia de aumento de coroa clínica. Este trabalho tem a intenção de discutir através de um relato de caso clínico os aspectos biomecânicos, operatórios e biológicos no tratamento de dentes com margens cervicais profundas. Sendo assim, conclui-se que a técnica de elevação da margem gengival com resina composta é vantajosa, pois elimina a necessidade de cirurgia permitindo a execução de restaurações indiretas em menos sessões clínicas, não gerando danos aos tecidos periodontais, desde que haja um bom acabamento e polimento, com estabelecimento de um correto perfil de emergência. (AU)

Research progress on conservative endodontic access cavities and its stress analysis of teeth / 口腔疾病防治

@#Conservative endodontic access cavity (CEC) is the first step of minimally invasive endodontics. After that operation, teeth retain the dental hard tissue, such as crest and peri-cervical dentin, to a large extent. It is of great significance to reduce the tissue excision and achieve a favorable prognosis. There are a variety of approaches and corresponding cavities in CEC. The methods to determine the medullary approach include X-ray localization, micro CT/cone beam CT localization and digital guide plate localization. Among them, X-ray film and micro CT/cone beam CT are simple and commonly used in the clinic. For more complex root canal systems, the use of a digital guide plate can establish a more accurate pulp opening pathway and reduce the unnecessary loss of tooth hard tissue. However, the positioning price of a digital guide plate is high, and it has not been widely used in the clinic. The hole types of CEC include minimally invasive medullary hole type, super conservative minimally invasive medullary hole type, "Truss" hole type and cutting end hole type. The stress analysis of CEC and traditional endodontic access (TEC) cavity are mainly based on the loading of teeth by a universal mechanical testing machine in vitro, finite element analysis and clinical observation. Most scholars’ studies have shown that minimally invasive endodontics can improve the fracture resistance of teeth, but the differential capacities of CEC and TEC remain controversial. How does on balance the purpose of pulp treatment and the maximum retention of tooth tissue? Further exploration is still needed.

Restorative treatment decisions regarding approximal and occlusal carious lesions among general dental practitioners in Palestine

Aim: To investigate restorative decisions made by dentists and to examine what demographic characteristics are associated with the decisions for managing approximal and occlusal lesions. Methods: A questionnaire was randomly sent to 900 Palestinian dentists. It noted the demographic details of the dentists and the years of experience. The questionnaire evaluated the respondents for their treatment decisions regarding approximal and occlusal carious lesions. The data was analyzed using the IBM SPSS statistics for windows. The associations between gender and years of experience of the respondents and their restorative decisions were assessed. Results: The response rate was 58.2%. For occlusal carious lesions, 93.9% of the respondents would postpone operative treatment until the lesion was in dentine (grade 3 to 5). For approximal lesions, intervention was deemed appropriate by 92.6% of the respondents when there was radiographic evidence of a carious lesion reaching the DEJ or deeper. Around 53% preferred to prepare approximal lesions according to the traditional principles of cavity preparation. For both approximal and occlusal lesions, the participants opted for resin composites. Statistically, there was a significant association between the restorative decisions with the years since graduation and gender. Conclusion: The study showed variations between the treatment decisions of Palestinian dentists. The subjects chose conservative treatment plans but still adhered to traditional learned practices especially when cavity preparation for approximal lesions was concerned. The years since graduation and gender played a significant role in the choice of treatment opted for. Resin composites seemed to be a popular choice for treatment

Molars Fracture Resistance with Class II Cavities Restored with Different Resin - Based Materials / Resistência à Fratura de Molares com Cavidades Classe II Restauradas com Diferentes Materiais à Base de Resina

The teeth weakening due to the preparation of class II mesio-occluso-distal cavities is a challenge for the clinician. The objective of this study was to evaluate the molars fracture resistance with class II mesio-occluso distal cavities restored with different restorative techniques and materials. Forty extracted molars were divided into 5 groups: Group 1 ­ intact healthy teeth (positive control); Group 2 ­ unrestored teeth with mesio-occluso distal class II cavities (negative control); Groups 3 to 5 ­ restored teeth with standardized dimensions. In groups 3 to 5, the cavities were restored with flow resin only, flow resin coated with a nano-hybrid resin, and nano-hybrid resin only, respectively. All specimens were tested for resistance to fracture using an axial compressive load, a metallic sphere measuring 8 mm in diameter on a universal testing machine EMIC DL-2000. A 10 kN load cell operated at a speed of 5 mm/min until the tooth fracture. Data were subjected to analysis of variance and Tukey's tests (α = 0.05). Group 3 showed higher fracture strength (2243.1 ± 473.7N) when compared to groups 2, 4 and 5. This difference was statistically significant (p<0.05). The fracture strength of teeth restored with flow mesio occluso-distal restorations was similar to that of intact natural teeth. (AU)

O enfraquecimento dos dentes devido às preparações de cavidades mesio-ocluso-distal é um desafio para o clínico. O objetivo deste estudo foi avaliar a resistência à fratura de molares com cavidades mesio-ocluso-distais classe II restauradas com diferentes técnicas e materiais restauradores. Quarenta molares extraídos foram divididos em 5 grupos: Grupo 1 ­ dentes saudáveis intactos (controle positivo); Grupo 2 ­ dentes não restaurados com cavidades mesio-occluso-distais classe II (controle negativo); Grupos 3 a 5 ­ dentes restaurados com dimensões padronizadas. Nos grupos 3 a 5, as cavidades foram restauradas apenas com resina flow, resina flow recoberta com uma resina nanohíbrida e somente resina nano-híbrida, respectivamente. Todas as amostras foram testadas quanto à resistência à fratura usando uma carga compressiva axial, usando uma esfera metálica medindo 8 mm de diâmetro em uma máquina de teste universal EMIC DL-2000. Uma célula de carga de 10 kN operava a uma velocidade de 5 mm/min até a fratura do dente. Os dados foram submetidos à análise de variância e testes de Tukey (α = 0,05). O grupo 3 apresentou maior resistência à fratura (2243,1 ± 473,7N) quando comparado aos grupos 2, 4 e 5. Essa diferença foi estatisticamente significante (p <0,05). A resistência à fratura dos dentes restaurados com resina flow foi semelhante à dos dentes naturais intactos. (AU)

Assessment of Marginal Adaptation Before and After Thermo-Mechanical Loading and Volumetric Shrinkage: Bulk Fill versus Conventional Composite / Evaluación de la Adaptación Marginal Antes y Después de la Carga Termomecánica y la Contracción Volumétrica: Relleno Bulk-Fill- versus Compuesto Convencional

ABSTRACT: The objective of the study was to evaluate marginal adaptation of Class II mesial-occlusal-distal (MOD) restorations before and after thermo-mechanical loading and volumetric shrinkage of the bulk-fill vs conventional composite resin. For marginal adaptation assessment, 24 Class II MOD cavities with cervical margins extending 1.0 mm below (distal) and 1.0 mm beyond (mesial) the cement-enamel junction were prepared in extracted human molars. The teeth were filled as follows: Group A - bulk-fill with SureFil SDR flow (first increment, 4 mm; second increment, 2 mm); Group B - bulk-fill with SureFil SDR flow as a base (first increment, 4 mm) and covered with the conventional nanohybrid composite Esthet-X HD (second increment, 2 mm); and Group C - incrementally filled with Esthet-X HD. Marginal adaptation was evaluated by scanning electron microscopy before and after thermomechanical loading (240,000 loading cycles and simultaneous 600 thermal cycles). To evaluate volumetric polymerization shrinkage, a semi-spherical mold was filled with the tested composites and placed in an AccuVol device after light curing. Both before and after loading, marginal adaptation in cervical dentin was superior (p < 0.05) for Groups A and B compared with Group C. In cervical enamel, Group B showed better marginal adaptation than Group C, and Group A presented intermediary results, between Groups B and C. Furthermore, bulk-fill flow resulted in greater shrinkage than Esthet-X HD. A significant improvement of marginal adaptation was observed when bulkfill flow was used instead of conventional composite resin both before and after thermomechanical loading. However, the bulk-fill flow presented higher volumetric polymerization shrinkage than the conventional composite.

RESUMEN: El objetivo de este trabajo consistió en evaluar la adaptación marginal de las restauraciones mesiales-oclusales-distales (MOD) de Clase II antes y después de la carga termo-mecánica y la contracción volumétrica de la carga compuesta de resina "bulk-fill" en comparación con resina convencional. Para la evaluación de adaptación, se prepararon 24 cavidades MOD de Clase II en molares humanos extraídos, los que se restauraron de la siguiente manera: Grupo A: restaurado con resina fluida Bulk-Fill SureFilSDR (primer incremento, 4 mm; segundo incremento, 2 mm); Grupo B: restaurado con resina fluida Bulk-Fill SureFil SDR (primer incremento, 4 mm) y cubierto con resina compuesta nanohíbrida Esthet-X HD (segundo incremento, 2 mm); y Grupo C - rellenado incrementalmente con Esthet-X HD. La adaptación marginal se evaluó mediante microscopía electrónica de barrido antes y después de la carga termomecánica (240.000 ciclos de carga y 600 ciclos térmicos simultáneos). Para evaluar la contracción volumétrica de la polimerización, se llenó un molde semiesférico con los compuestos probados y se colocó en un dispositivo AccuVol después del fotopolimerización. Tanto antes como después de la carga, la adaptación marginal en la dentina cervical fue superior (p <0,05) para los grupos A y B en comparación con el grupo C. En el esmalte cervical, el grupo B mostró una mejor adaptación marginal que el grupo C, y el grupo A presentó resultados intermedios, entre Grupos B y C. Se observó una mejora significativa de la adaptación marginal al utilizar la resina fluida Bulk-Fill en lugar de resina compuesta convencional tanto antes como después de la carga termomecánica. Sin embargo, la resina fluida 'Bulk-Fill' presentó una mayor contracción volumétrica de polimerización que el compuesto convencional.

Influence of cavo superficial enamel acid-etching on the microtensile bond strength of low-shrinkage composite resin / Influência do condicionamento ácido do ângulo cavo superficial na resistência adesiva de restaurações em um compósito de baixa contração de polimerização

Introduction: To prevent the shrinkage stresses produced during polymerization, composite resins of low polymerization shrinkage were developed. Objective: To evaluate the microtensile bond strength in class I cavities restored by acid-etching the cavosurface angle and with composite resins indicated for posterior teeth. Material and method: 48 healthy molars were selected and divided into six groups (n = 8), considering that the cavosurface enamel of three groups was etched with 35% phosphoric acid. The teeth were restored with the Clearfil SE Bond adhesive system and Filtek Z350 XT, Empress Direct, and Charisma Diamond composite resins, which were light-cured for 40 seconds. After 24 hours, the teeth were taken to a cutting machine, which produced sections in the buccolingual and mesiodistal directions. This resulted in toothpicks of 0.9×0.9 mm that were taken to the universal testing machine for the microtensile bond strength test. Statistical analysis was performed with ANOVA and Tukey's test (p < 0.05). Result: There was no statistically significant difference between the groups evaluated. Conclusion: Acid-etching the cavosurface angle did not affect the performance of restorations, probably due to the adhesive system used.

Introdução: Com o intuito de se evitar as tensões geradas durante a contração de polimerização das resinas compostas, foram desenvolvidas as resinas compostas de baixa contração de polimerização. Objetivo: Avaliar a resistência à microtração em cavidades classe I restauradas com tratamento ácido do ângulo cavo superficial e resina composta indicada para dentes posteriores. Material e método: Foram selecionados 48 molares hígidos que foram divididos em 6 grupos (n=8), sendo que 3 desses tiveram o esmalte cavo superficial condicionado com ácido fosfórico a 35%. Os dentes foram restaurados com o sistema adesivo Clearfil SE Bond e as resinas compostas Filtek Z350 XT, Empress Direct e Charisma Diamond, fotoativadas por 40 segundos. Após 24 horas, os dentes foram levados para máquina de corte, na qual foram realizados cortes no sentido vestíbulo-lingual e no sentido mésio-distal obtendo - se palitos de 0,9×0,9 mm que foram levadas para a máquina de ensaio universal para a realização do teste de microtração. Para análise estatística foi realizado análise de variância e teste de Tuckey (p < 0,05). Resultado: Não houve diferença estatística significante entre os grupos avaliados. Conclusão: O condicionamento ácido do ângulo cavo superficial não influenciou no desempenho das restaurações provavelmente devido ao sistema adesivo utilizado.

Influence of Cavity Dimensions on Microleakage of Two Bulk-Fill Composite Resins

Objective: To evaluate the effect of cavity dimensions on the amount of microleakage in two different types of bulk-fill composite resins. Material and Methods: Forty class II cavities were prepared in the mesial and distal surfaces of human molars without any carious lesions. The samples were divided into 4 groups (n=10): Group 1: cavities with 3 mm of buccolingual width (known as the smaller cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 2: cavities with 6 mm of buccolingual width (larger cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 3: cavities with 3 mm of buccolingual width, filled with X-Tra Base composite resin; and Group 4: cavities with 6 mm of buccolingual width, filled with X-Tra Base composite. After the specimens were thermocycled for 500 cycles at 5/55°C, they were immersed in 1% methylene blue for 24 hours, and then cut into sections mesiodistally in the longitudinal axis of each tooth. Then, the samples were scored regarding the amount of dye penetration in two occlusal and gingival areas under a stereomicroscope (x32). Data was submitted to Kruskal- Wallis and Mann-Whitney tests. Results: The highest degrees of microleakage in larger cavities filled with X-Tra Base among the four groups. There was a significant statistic difference (p=0.012) between large and small cavities filled with X-Tra Base (Groups 3 and 4); however, there was no significant difference between the two cavity sizes of Tetric N-Ceram Bulk-filled groups. Conclusion: Microleakage of composite resins depends on the dimension of the cavity and the type of composite resin used.

Assessment of a conservative approach for restoration of extensively destroyed posterior teeth

Abstract Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. Objective This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. Methodology Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). Results Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. Conclusions Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

Influence of enamel acid-etching on mechanical properties and nanoleakage of resin composite after aging

The aim of this study was to evaluate how acid-etching of the cavosurface enamel in Class I resin composite restorations influences the bond strength to the pulpal wall and the restoration, Knoop microhardness and nanoleakage after thermomechanical aging. For this research 76 fresh human molars were selected and restored with Silorane or Clearfil SEBond/Z350XT composite divided in 4 groups (Silorane system restored with or without enamel cavosurface acid-etching and Clearfil SEBond/Z350XT with or without enamel cavosurface acid-etching). To induce artificial aging, samples were subjected to thermomechanical cycling through 200,000 and thermal cycling between 5 and 55 °C with 30 second filling and 15-second drainage steps. Microhardness and microtensile bond strength were evaluated in 32 teeth (n=8) each and nanoleakage evaluation was performed in 12 teeth (n=3). Samples restored by Clearfil SEBond/Z350 XT without cavosurface acid-etching showed significantly lower microtensile bond strength results. The resin composite Z350XT presented higher values of Knoop microhardness. It was observed little or no infiltration for Silorane groups and moderate infiltration for Clearfil SE Bond groups. Acid-etching of the cavosurface enamel during restoration procedure with Clearfil Se Bond resulted in a stronger bond after thermomechanical cycling. Silorane groups showed less infiltration than Clearfil SE Bond groups (AU)

Comparación de la adhesión de la resina en cavidades clase I de Black conformadas con dos tipos de fresa / Comparison of adhesion of the resin to the dental structure class I GV Black using two types of burs

Se desarrolló un estudio observacional comparativo, durante la cual se trabajó con toda la población estudio, la que estuvo constituida por 38 terceros molares sanos recolectados luego de extracción por causas odontológicas justificadas y con el consentimiento de los respecti-vos pacientes, cuyas edades oscilaron entre 20 y 25 años; la misma se distribuyó en dos grupo A (19) y grupo B (19); con el propósito de comparar la adherencia de la resina 3MZ250 en cavidades clase I de Black, utilizando dos tipos de fresas jota cilíndricas, de estas una de grano fino y otra grueso, en terceros molares in vitro. La investigación se desarrolló en cuatro etapas obteniendo los siguientes resultados: se estableció que en el grupo A, la adhesión de la resina a la estructura dentaria requirió una mayor fuerza de tracción promediando 215,49 N para desprenderla; mientras que en el B resultó de 167,7 N. El análisis estadístico mediante la prueba T permitió establecer que la diferencia de la resistencia a la tracción de la resina entre los grupos A y B resultó significativa. El uso de fresas de grano fino en la conformación de las cavidades clase I de Black crea paredes más lisas que permiten una mejor adhesión de la resina a la estructura dentaria; por lo que resultan más resistentes ante fuerzas de tracción.

A comparative observational study was carried out including the entire study population of 38 healthy third molars collected after extraction for medically justified reasons and with the consent of the respective patients. The ages ranged were from 20 to 25 years. It was distribu-ted in two strata: group A (19) and group B (19) in order to compare the adherence of resin 3MZ250 in class I GV Black cavities by using two types of cylindrical dental burs brand jota, the one of fine grained and the other thick, in third molars in vitro. The research was develo-ped in four stages obtaining the following results: in group A, the adhesion of the resin to the dental structure required a higher tensile force averaging 215.49 N to detach and in group B was 167.7 N. Statistical analysis using the T test allowed establishing that the difference in the tensile strength of the resin between groups A and B was significant. The use of dental burs of fine grained in the formation of class I GV Black cavities creates smoother walls that allow a better adhesion of the resin to the dental structure; so they are more resistant to tensile forces.

Técnicas para reduzir os efeitos da contração de polimerização das resinas compostas fotoativadas / Techniques for reducing the effects of polymerization shrinkage of composites photoactivated resins

Introdução: uma complicação inerente a todas as resinas compostas é o stress gerado pela contração de polimerização. As resinas compostas da atualidade, após a polimerização, perdem entre 2% a 3% de todo o seu volume. Essa perda pode acarretar em alterações fortemente comprometedoras a nível micro e macroscópico. Objetivo: abordar a importância do uso de técnicas e manobras clínicas, que visam diminuir a contração de polimerização das resinas compostas, reduzindo seus efeitos na cavidade, para que se tenha um procedimento restaurador com elevado índice de sucesso clínico e boa aceitação pelos pacientes. Material e Métodos: foi realizada uma revisão da literatura por meio de uma busca bibliográfica nas seguintes bases de pesquisa online: PUBMED/MEDLINE, LILACS, BBO e SCIENCE DIRECT, através do rastreio de artigos relevantes publicados entre o período de 2000 a 2015. Resultados: comparando as formas de ativação dos compósitos, os compósitos fotopolimerizáveis possuem um menor escoamento e maior stress de contração se comparados a compósitos com ativação química, isso se dá devido à fotoativação que se destaca por ser uma reação rápida quando comparada a outros métodos, não dispondo de tempo para a resina se acomodar na cavidade e ter uma boa interação com o sistema adesivo previamente aplicado, levando a grande parte dos problemas clínicos das restaurações. Conclusão: questionamentos sobre os efeitos da contração de polimerização, ainda não foram completamente elucidados no meio científico, por isso algumas técnicas como a escolha de fotopolimerizadores a LED, manutenção da fase pré gel, manutenção do Fator C e técnica de inserção incremental, podem ser usadas para minimizar os efeitos dessa contração nas restaurações feitas com resina, afim de reduzir insucessos como, sensibilidade pós operatória, infiltração marginal e riscos de agressão pulpar levando a uma maior longevidade dos procedimentos restauradores com materiais resinosos. (AU)

Introduction: a complication inherent in all composite resins is the stress generated by the polymerization contraction. The present composite resins, after polymerization, lose between 2% and 3% of their entire volume. This loss can lead to strongly compromising micro and macroscopic changes. Objective: to address the importance of using technical and clinical maneuvers, which aim to reduce polymerization shrinkage of composite resins, reducing its effects in the cavity, in order to have a restorative procedure with high clinical success rate and good patient acceptance. Material and Methods: a review of the literature through a literature search in the following search online databases was performed: PubMed/MEDLINE, LILACS, BBO and SCIENCE DIRECT, through the screening of relevant articles published between 2000 to 2015. Results: comparing both activation of composites, the dental composites have a lower flow and higher stress of contraction compared to composites with chemical activation, this is the due to photoactivation that stands out for being a quick reaction when compared to other methods, not providing time for the resin to settle in well and have a good interaction with the previously applied adhesive system, leading to much of the clinical problems of restorations. Conclusion: questions about the effects of polymerization shrinkage have not been fully elucidated in the scientific community, so some techniques such as the choice of curing lights to LED, the pre gel phase maintenance, maintenance of Factor C and incremental insertion technique can It is used to minimize the effects of this contraction in restorations made with resin in order to reduce failures as post-operative sensitivity, microleakage and pulp assault risks leading to increased longevity of restorative procedures with resinous materials. (AU)

Abrasão ultrassônica: uma alternativa de preparo cavitário para o paciente infantil / Ultrasonic abrasion: an alternative in the performance of cavity preparation in childhood

A técnica da abrasão ultrassônica é realizada com o uso de pontas CVD (Chemical Vapor Deposition), que são formadas através da união química da peça única do diamante à haste metálica, acopladas ao aparelho de ultrassom. Assim, o corte do esmalte e da dentina é feito por oscilação dessas pontas diamantadas e não por ação mecânica, o que promove um desgaste preciso e um preparo conservador da cavidade. Essa técnica proporciona inúmeras vantagens para o profissional e para o paciente, pois diminui a sensação de barulho, pressão, vibração e calor, além de possibilitar um tratamento sem anestesia local e apenas com uso de isolamento relativo, tendo uma boa aceitação pelos pacientes, destacando-se, assim, como aspecto de grande relevância na odontopediatria, para o preparo cavitário. O presente trabalho tem por objetivo descrever um caso clínico utilizando a técnica de abrasão ultrassônica para o preparo cavitário nos dentes 51 e 61 acometidos por lesão cariosa, de um paciente de 04 anos, abordando os aspectos positivos e negativos relacionados a essa técnica

The technique of ultrasonic abrasion is carried out using tips CVD (Chemical Vapor Deposition), which areformed by the chemical union of one piece of diamond to metal rod coupled to the ultrasonic device. Thus, the cut enamel and dentin is done by oscillation of these diamond burs and not by mechanical action, which promotes an accurate wear and a conservative cavity preparation. This technique provides numerous advantages for the professional and the patient, because it reduces the sensation of noise, pressure, vibration and heat, besides enabling a treatment without local anesthesia and only with the use of relative isolation, with good acceptance by patients, highlighting was thus as an aspect of great relevance in pediatric dentistry for cavity preparation. This paper aims to describe a clinical case using the technique of ultrasonic abrasion for cavity preparation in teeth 51 and 61 affected by carious lesion of a patient of 04 years, addressing the positive and negative aspects to this technique

Effects of different cavosurface margins on color matching of the resin composite / 北京大学学报(医学版)

Objective: To evaluate effects of color matching of different cavosurface margins on the resin composites in vitro.Methods:Twenty extracted human premolars with an A 2 shade buccal surface were used in this study .Rectangular shaped cavities (3.0 mm depth, 2.0 mm width, 2.0 mm length) were prepared in the center of the buccal surfaces .The gingival and occlusal cavosurface margins were prepared to be either shoulder or bevel;the other cavosurface margins remained vertical .Ten teeth were filled with Clearfil AP-X (AP), the other ten with Clearfil Majesty (MJ) and light cured.The color difference at the cavosurface margin area was measured using a spectrophotometer ( CrystalEye ) and evaluated by 3 observers subjectively .The data were statistically analyzed using repeated measures ANOVA and Chi-square test .Results:When measured by CrystalEye , the color difference between the tooth and resin composite was reduced from the center of restoration to the cavosurface margin area .Both objective and subjective evaluations showed that for AP , the color difference at the cavosurface margin area had no statistical difference among 3 types of the margins; for MJ, the color difference at bevel margin area was significantly smaller than that at the vertical margin area .Conclusion: The resin com-posite restorations produced the color matching at marginal area .The color matching of resin composites with higher diffused light transmission property is more susceptible to the type of cavosurface margins . Preparing bevels may reduce the color difference between the restoration and tooth surface .

Effect of Er: YAG laser and diamond drill on hybrid layer morphology obtained with self-etch adhesive - analysis by SEM and confocal laser scanning microscopy (CLSM)

ABSTRACT Introduction and Objective: This study aimed to evaluate the effect of Er:YAG (L) and diamond drills (DD) on: 1) the microshear bond strength (MPa); 2) the adhesive interface of two-step (TS) - Adper Scotchbond Multipurpose and one-step (OS) adhesives - Adper EasyOne, both from 3M ESPE. Material and methods: According to the preparation condition and adhesives, the samples were divided into four groups: DD_TS (control); DD_OS; L_TS and L_OS. 60 bovine incisors were randomly divided into experimental and groups: 40 for microshear bond strength (n = 10) and 20 for the adhesive interface morphology [6 to measure the thickness of the hybrid layer (HL) and length of tags (t) by CLSM (n = 3); 12 to the adhesive interface morphology by SEM (n = 3) and 2 to illustrate the effect of the instruments on dentine by SEM (n = 1)]. To conduct the microshear bond strength test, four cylinders (0.7 mm in diameter and 1 mm in height with area of adhesion of 0.38 mm) were constructed with resin composite (Filtek Z350 XT - 3M ESPE) on each dentin surface treated by either L or DD and after adhesives application. Microshear bond strength was performed in universal testing machine (EMIC 2000) with load cell of 500 kgf and a crosshead speed of 0.5 mm / min. Adhesive interface was characterized by thickness of hybrid layer (HL) and length of tags (t) in nm, with the aid of UTHSCSA ImageTool software. Results: Microshear bond strength values were: L_TS 34.10 ± 19.07, DD_TS 24.26 ± 9.35, L_OS 33.18 ± 12.46, DD_OS 21.24 ± 13.96. Two-way ANOVA resulted in statistically significant differences only for instruments (p = 0.047). Mann-Whitney identified the instruments which determined significant differences for HL thickness and tag length (t). Concerning to the adhesive types, these differences were only observed for (t). Conclusion: It can be concluded that 1) laser Er:YAG results in higher microshear bond strength values regardless of the adhesive system (TS and OS); 2) the tags did not significant affect the microshear bond strength; 3) the adhesive interface was affected by both the instruments for cavity preparation and the type of adhesive system used.

Marginal microleakage of cavities prepared with Er:YAG laser on primary teeth in vitro / 北京大学学报(医学版)

Objective:To investigate the marginal microleakage after cavity preparation by Er:YAG la-ser and conventional bur applying different adhesive systems , conditioning surface with acid etching or not.Methods:In the study, 50 primary teeth were divided into 5 groups.(1) Bur+etch-and-rinse sys-tem, (2) Bur+self-etching system, (3) Er:YAG laser+etch-and-rinse system, (4) Er:YAG laser+self-etching system, (5) Er:YAG laser+none-etched.The class V cavities were all filled with composite resin.The microleakage tests were performed , observed and scored under stereomicroscope .Results:Bur+etch-and-rinse group had higher microleakage than Er:YAG laser +etch-and-rinse group , and Bur+self-etching group had higher microleakage than Er:YAG laser +self-etching group ( P<0 .05 ) . There was no difference between Er:YAG laser+etch-and-rinse group and Er:YAG laser+self-etching group, while they had significantly lower microleakage than that of Er:YAG+none-etched group.Con-clusion:Composite resin restoration showed less marginal microleakage when all-in-one self-etch system was used after irradiation by Er:YAG laser on primary teeth .

Evaluation of bond strength of silorane and methacrylate based restorative systems to dentin using different cavity models

OBJECTIVE: The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) to dentin of two different restorative systems: silorane-based (P90), and methacrylate-based (P60), using two cavity models. MATERIAL AND METHODS: Occlusal enamel of 40 human third molars was removed to expose flat dentin surface. Class I cavities with 4 mm mesial-distal width, 3 mm buccal-lingual width and 3 mm depth (C-factor=4.5) were prepared in 20 teeth, which were divided into two groups (n=10) restored with P60 and P90, bulk-filled after dentin treatment according to manufacturer's instructions. Flat buccal dentin surfaces were prepared in the 20 remaining teeth (C-factor=0.2) and restored with resin blocks measuring 4x3x3 mm using the two restorative systems (n=10). The teeth were sectioned into samples with area between 0.85 and 1.25 mm2 that were submitted to µTBS testing, using a universal testing machine (EMIC) at speed of 0.5 mm/min. Fractured specimens were analyzed under stereomicroscope and categorized according to fracture pattern. Data were analyzed using ANOVA and Tukey Kramer tests. RESULTS: For flat surfaces, P60 obtained higher bond strength values compared with P90. However, for Class I cavities, P60 showed significant reduction in bond strength (p<0.05). No statistical difference between restorative systems was shown for Class I cavity model (p>0.05), or between Class I Cavity and Flat Surface group, considering P90 restorative system (p>0.05). Regarding fracture pattern, there was no statistical difference among groups (p=0.0713) and 56.3% of the fractures were adhesive. CONCLUSION: It was concluded that methacrylate-based composite µTBS was influenced by cavity models, and the use of silorane-based composite led to similar bond strength values compared to the methacrylate-based composite in cavities with high C-factor. .

Efeito do laser ER:YAG e ponta diamantada na morfologia da camada híbrida obtida com um adesivo autocondicionante: resistência de união ao microcisalhamento análise por MEV e MLCF / Effect of laser ER: YAG and a diamond bur in the morphology of the hybrid layer obtained with a self-etching adhesive. SEM analysis and MLCF and bond strength microshear

Este estudo tem como objetivo avaliar o efeito de laser de Er: YAG (L) e ponta diamantada (B) sobre a força de resistência ao microcisalhamento (MPa) e o efeito sobre a interface adesiva de adesivos condiciona e lava (CL) ­ Adper Scotchbond Multiuso e autocondicionante (CS) ­ Adper EasyOne, ambos da 3M ESPE. Foram constituídos 4 grupos segundo instrumentos e adesivos: B_CL (controle); B_CS; L_CL e L_CS. 60 incisivos bovinos foram randomicamente divididos nos experimentos e grupos: 40 para força de resistência ao microcisalhamento (n=10) e 20 para morfologia da interface adesiva (6 para mensuração da espessura da camada hibrida (CH) e comprimento de tags (t) por MLCF (n=3); 12 para morfologia da interface adesiva por MEV (n=3) e 2 para ilustração o efeito dos instrumentos sobre dentina por MEV (n=1). Para o ensaio de microcisalhamento foram confeccionados 4 cilindros de resina composta Filtek Z350 XT ­ 3M ESPE (0,7 mm de diâmetro por 1 mm de altura e área de adesão de 0,38 mm2 ) sobre cada superfície de dentina tratada pelos instrumentos e adesivos. O ensaio de resistência de união ao microcisalhamento foi realizado em máquina de ensaio universal EMIC 2000, com célula de carga de 500 Kgf e velocidade de 0,5 mm/min. A interface adesiva foi caracterizada pela espessura da camada hibrida (CH) e comprimento de tags (t) em µm, com o software UTHSCSA Imagetool. Os valores de resistência adesiva ao microcisalhamento foram L_CL 34,10 ± 19,07 MPa, B_CL 24,26 ± 9,35 MPa, L_CN 33,18 ± 12,46 MPa, B_CN 21,24 ± 13,96 MPa. Anova two-way resultou em diferença estatisticamente significativa somente para instrumentos (p=0,047). Teste de Mann-Whitney identificou os instrumentos determinam diferenças significativas para de espessura de CH e comprimento de (t). Para adesivos estas diferenças só foram observadas para (t). Pode-se concluir que 1) Laser de Er:YAG resulta em maiores valores de resistência adesiva ao microcisalhamento, independente do sistema adesivo utilizado (CL ou CS). 2) Os tags não tem efeito significativo na resistência adesiva ao microcisalhamento. 3) A interface adesiva é afetada tanto pelos instrumentos utilizados para o preparo cavitário como pelo tipo de sistema adesivo empregado

This study aims to evaluate the effect of Er: YAG (L) and bur (B) on the strength of resistance microshear (MPa) and the effect on the interface adhesive stickers and wash conditions (CL) - Adper Scotchbond Multipurpose and self (CS) - Adper EasyOne, both from 3M ESPE. Were formed 4 groups according tools and adhesives: B_CL (control); B_CS; L_CL and L_CS. 60 bovine incisors were randomly divided into experimental and groups: 40 to force microshear resistance (n = 10) and 20 for the adhesive interface morphology (6 to measure the thickness of the hybrid layer (CH) and length of tags (t) by MLCF (n = 3); 12 to the adhesive interface morphology by SEM (n = 3) and 2 to illustrate the effect of the instruments on dentine by SEM (n = 1). Microshear For testing four cylinders were fabricated composite Filtek Z350 XT - 3M ESPE (0.7 mm in diameter and 1 mm in height and area of adhesion of 0.38 mm) on each dentin surface treated by tools and adhesives. Testing of bond strength was performed in microshear FDMS universal testing machine 2000 with a load cell of 500 kgf and a speed of 0.5 mm / min. Adhesive interface was characterized by layer thickness hybrid (HC) and length of tags (t) in nm, with software UTHSCSA ImageTool. Values of bond strength to microshear L_CL were 34.10 ± 19.07, 24.26 ± 9.35 B_CL, L_CN 33.18 ± 12.46, 21.24 ± 13.96 B_CN. Anova two- way resulted in statistically significant only for instruments (p = 0.047). Mann-Whitney identified instruments to determine significant differences CH thickness and length (t). adhesives for these differences were only observed for (t). It can be concluded that 1) Laser Er: YAG results in higher bond strength to the microshear, regardless of the adhesive system (CL and CS). 2) The tags have no significant effect on bond strength to microshear. 3) The adhesive interface is affected by both instruments for cavity preparation and the type of adhesive system used