Thermal-induced polymerization shrinkage in silorane versus methacrylate based resin composite / Contração de polimeração induzida termicamenteem resinas compostas a base de silorano e metacrilato

Shrinkage is a limitation of resin composite, compromising the clinical longevity of the restorative procedure. In an attempt to reduce their harmful effects, researchers have studied monomers with lower values of contraction. As a result, low-shrinkage composites were developed. This study evaluated quantitatively the shrinkage as a function of power density increase based on methacrylates, comparing them with silorane based resin, and qualitatively regarding gap formation between the adhesive interface as function of tooth substrate. Resin Filtek P90 and Filtek Z250 were polymerized with the device Blue Star 3 with 200, 400, 600, 800 and 1000 mW/cm2 keeping volume constant in 12 mm3. For qualitative analysis of restorative interface, class V cavity preparations in bovine incisors were restored in (2x2x2 mm3), photoactivated with the same values of irradiance, and analyzed by scanning electron microscopy at the interface of the wall surrounding enamel, dentin and axial. The quantitative results of the polymerization shrinkage were analyzed by two-way ANOVA and Tukey's test (p<0.05), while qualitative data were submitedd to Mann-Whitney's, Kruskal-Wallis' and Miller's tests. The progressive increase in power density directly influenced the polymerization shrinkage of the materials studied, although the silorane based resin demonstrated significantly lower values. The marginal integrity was influenced by the dental substrate and the power density used.

Este estudo avaliou quantitativamente a contração de polimerização em função do aumento dos valores de densidade de potência irradiados em compósitos à base de metacrilatos e silorano, e qualitativamente a interface restauradora em relação à abertura de fendas marginais, em função da variação do tipo de substrato dentário. As resinas Filtek Z250 e Filtek P90 foram fotoativadas com 200, 400, 600, 800 e 1000 mW/cm2, em um volume constante de 12mm3, e os valores de contração foram aferidos por meio da máquina de ensaios universal. Para análise qualitativa da interface restauradora, preparos cavitários classe V de (2x2x2mm3) foram restaurados em incisivos bovinos, fotoativados com os mesmos valores de irradiância, e analisados em microscopia eletrônica de varredura nas interfaces da parede circundante em esmalte, parede circundante em dentina e parede axial. Os resultados quantitativos da contração de polimerização foram analisados pelo teste ANOVA a dois critérios e Tukey (p<0,05) enquanto para os dados qualitativos os testes Mann- Whitney, Kruskal-Wallis e Miller foram empregados. O aumento progressivo da densidade de potência influenciou diretamente na contração de polimerização dos materiais estudados, não obstante a resina composta à base de silorano ter demonstrado valores significativamente menores. A integridade marginal sofreu influência do substrato dentário bem como da densidade de potência utilizada, para as duas resinas estudadas.

Nine-year clinical evaluation of composite resins in Class III restorations / Avaliação de nove anos de restaurações de classe III em resina composta

The aim of this study was to evaluate thenine-year clinical performance of Class III composite restorations using two microhybrid anterior composite resins [Magic™-Vigodent/(F) and Z100™-3M ESPE/(Z)]. Material and Methods: The study was a randomized controlled trial, following the splitmouth design. Seventy restorations were placed, thirty-five for each resin composite into 35 patients. The restorations were placed by one operator according to the manufacturers’ specifications. Two independent evaluators conducted the clinical evaluation using modified USPHS criteria. After nine years, 56 restorations (28F-28Z) were evaluated. Data were analyzed using Chi-square, Exact Fisherand McNemar tests (p < 0.05). Results: Nopost operative sensitivity, secondary caries and loss of anatomic form was observed after nine-years for both composites. There were no significant differences between the two composites tested at baseline and after nine-years. Significant differen ces for Z and Frestorations between baseline and nine-year with respect to color matching and for F regarding themarginal integrity were detected. Conclusion: The clinical performance of both materials was consideredacceptable after the 9-year evaluation...

Objetivo: O objetivo deste estudo foi avaliar após nove anos a performance clínica de restaurações de classe III em resina composta, utilizando-se duas resinas microhíbridas para dentes anteriores [Magic-Vigodent/(F) e Z100-3M ESPE/(Z)]. Material e Métodos: Trata-se de um estudo clínico controlado aleatório, o qual utilizou o desenho de boca dividida.Setenta restaurações foram realizadas em trinta e cinco pacientes, sendo trinta e cinco para cada resina composta. As restaurações foram realizadas por um único operador seguindo as especificações dos fabricantes. Dois avaliadores independentes avaliaram as restaurações utilizando-se o critério USPHS modificado. Após nove anos, 56 restaurações(38F – 28Z) foram avaliadas. Os dados foram analisados por meio dos testes Qui-quadrado, Exato de Fisher e McNemar (p < 0,05). Resultados: Não foram detectados sensibilidade pós-operatória, cárie secundária e perda de forma anatômica no período analisado para ambas resinas. Não houve diferenças entre o período inicial e de nove anos para as resinas testadas, exceto para Z e F foram em relação à a cor e para a integridade do material para F. Conclusão: O comportamento clínico das duas resinas testadas foi considerado adequado após nove anos de avaliação...

Effect of sealants in the composite surface roughness after tooth brushing / Efeito de selantes na rugosidade de resinas compostas após a escovação simulada

This in vitro study evaluated the influence of 4 surface sealers on the surface roughness of composite resins. Fifty specimens were divided into 10 groups, as follows: G1. (Control 1) Concept resin; G2. Concept + Fortify; G3. Concept + Biscover; G4. Concept + Lasting Touch; G5. Concept + Fill Glaze; G6. (Control 2) Esthet X; G7. Esthet X + Fortify; G8. Esthet X + Biscover; G9. Esthet X + Lasting Touch; G10. Esthet X + Fill Glaze. Specimens (15mm in length, 4 mm in depth and 5 mm in width) were made using a matrix and were stored in distilled water at 37ºC for 24 hours. After storage, specimens were polished using 320, 600 abrasive SiC paper under running water and the initial roughness was measured using a perfilometer. Surface sealers were applied and a new measurement of roughness was made. Specimens were submitted to 100,000 cycles of abrasive dentifrice brushing followed by another surface roughness measurement. Qualitative analysis was made by using SEM. Results were submitted to 3-way modified ANOVA (p<0.05) and Tukey's test. Results: Surface sealant provided smoother surfaces for both tested composite resins (G2=0.0727, G3=0.0147, G4=0.0307, G5=0.0253, G7=0.0173, G8=0.0333, G9=0.0480, G10=0,0480). After the abrasion test, the control group presented lower roughness surface (G1=0.0600, G6=0.1007). No statistical difference were found between Fortify (G2=0.0740, G7=0.0673) and Biscover (G7=0.0440). Lasting Touch presented rougher surfaces in relation to the other groups (G4= 0.1253, G9=0.0980), followed by Fill Glaze (G5=0.0933, G10= 0.0847). The application of surface sealant did not provide roughness optimization after tooth brushing simulation for the 2 composite resins tested.

Este estudo avaliou, in vitro, a influência de 4 selantes de superfície na rugosidade de duas resinas compostas. Cinqüenta espécimes foram confeccionados e divididos em 10 grupos com 5 espécimes cada, em função da combinação entre resina composta e selante de superfície, sendo: G1. Controle Concept; G2. Concept + Fortify; G3. Concept + Biscover; G4. Concept + Lasting Touch; G5. Concept + Fill Glaze; G6. Controle Esthet X; G7. Esthet X + Fortify; G8. Esthet X + Biscover; G9. Esthet X + Lasting Touch; G10. Esthet X + Fill Glaze. Os espécimes (15mm X 4 mm X 5 mm) foram confeccionados e armazenados em água destilada à 37ºC por 24 horas. Após este período, os espécimes foram planificados com lixas de granulometria 320, 600 e a rugosidade inicial foi aferida. Aplicaram-se os selantes de superfície e uma nova aferição da rugosidade superficial foi realizada. Os espécimes foram submetidos a 100.000 ciclos de escovação, seguido de nova mensuração da rugosidade. Os resultados foram submetidos aos testes ANOVA a 3 critérios e Tukey. A aplicação do selante de superfície diminuiu a rugosidade superficial das resinas compostas testadas (G2=0,0727, G3=0,0147, G4=0,0307, G5=0,0253, G6=0,0960, G7=0,0173, G8=0,0333, G9=0,0480). Nenhuma diferença estatística foi encontrada entre o grupo Fortify (G2=0,0740, G7=0,0673) e Biscover (G7=0,0440). Os maiores valores de rugosidade foram apresentados pelo grupo Lasting Touch (G4= 0,1253, G9=0,0980), seguido do Fill Glaze (G5=0,0933, G10= 0,0847). A aplicação do selante de superfície não otimizou a rugosidade das duas resinas compostas testadas após o teste de abrasão simulada.

Soluções estéticas para alterações intrínsecas do esmalte dentário / Aesthetic solution for intrinsic alterations of dental enamel

A alta expectativa por tratamentos estéticos gerada pelos pacientes, associada a uma Odontologia cada vez menos invasiva, torna o tratamento das lesões intrínsecas de esmalte um desafio para o clínico. Desta forma, existe a necessidade da constante atualização e discussão sobre o tema para oferecer o tratamento mais conservador e, ao mesmo tempo, de excelência. Neste artigo serão apresentados e discutidos alguns casos clínicos representativos de situações mais frequentes de alterações do esmalte dentário, em que foram empregados diferentes tratamentos, desde os mais conservadores até os que envolvem algum desgaste dentário, visando o restabelecimento estético e funcional do esmalte.

The high expectations of the patients for aesthetic treatments associated to a less invasive Dentistry turns treatment of intrinsic lesions of enamel a challenge for clinicians. Thus constant update and discussion are needed in order to offer a more conservative approach and, at the same time, an excellent treatment. The present paper will present and discuss some clinical cases representing the most frequent situations of tooth enamel alterations, in which different treatments have been used, from the most conservative to those involving some tooth drilling, aiming at aesthetic and functional restoration of the enamel.

Minimal alterations on the enamel surface by micro-abrasion: in vitro roughness and wear assessments

ABSTRACT Objective: To evaluate the in vitro changes on the enamel surface after a micro-abrasion treatment promoted by different products. Material and Methods: Fifty (50) fragments of bovine enamel (15 mm × 5 mm) were randomly assigned to five groups (n=10) according to the product utilized: G1 (control)= silicone polisher (TDV), G2= 37% phosphoric acid (3M/ESPE) + pumice stone (SS White), G3= Micropol (DMC Equipment), G4= Opalustre (Ultradent) and G5= Whiteness RM (FGM Dental Products). Roughness and wear were the responsible variables used to analyze these surfaces in four stages: baseline, 60 s and 120 s after the micro-abrasion and after polishing, using a Hommel Tester T1000 device. After the tests, a normal distribution of data was verified, with repeated ANOVA analyses (p≤0.05) which were used to compare each product in different stages. One-way ANOVA and Tukey tests were applied for individual comparisons between the products in each stage (p≤0.05). Results: Means and standard deviations of roughness and wear (µm) after all the promoted stages were: G1=7.26(1.81)/13.16(2.67), G2=2.02(0.62)/37.44(3.33), G3=1.81(0.91)/34.93(6.92), G4=1.92(0.29)/38.42(0.65) and G5=1.98(0.53)/33.45(2.66). At 60 seconds, all products tended to produce less surface roughness with a variable gradual decrease over time. After polishing, there were no statistically significant differences between the groups, except for G1. Independent of the product utilized, the enamel wear occurred after the micro-abrasion. Conclusions: In this in vitro study, enamel micro-abrasion presented itself as a conservative approach, regardless of the type of the paste compound utilized. These products promoted minor roughness alterations and minimal wear. The use of phosphoric acid and pumice stone showed similar results to commercial products for the micro-abrasion with regard to the surface roughness and wear. .

The influence of "C-factor" and light activation technique on polymerization contraction forces of resin composite

OBJECTIVES: This study evaluated the influence of the cavity configuration factor ("C-Factor") and light activation technique on polymerization contraction forces of a Bis-GMA-based composite resin (Charisma, Heraeus Kulzer). MATERIAL AND METHODS: Three different pairs of steel moving bases were connected to a universal testing machine (emic DL 500): groups A and B - 2x2 mm (CF=0.33), groups C and D - 3x2 mm (CF=0.66), groups e and F - 6x2 mm (CF=1.5). After adjustment of the height between the pair of bases so that the resin had a volume of 12 mm³ in all groups, the material was inserted and polymerized by two different methods: pulse delay (100 mW/cm² for 5 s, 40 s interval, 600 mW/cm² for 20 s) and continuous pulse (600 mW/cm² for 20 s). Each configuration was light cured with both techniques. Tensions generated during polymerization were recorded by 120 s. The values were expressed in curves (Force(N) x Time(s)) and averages compared by statistical analysis (ANOVA and Tukey's test, p<0.05). RESULTS: For the 2x2 and 3x2 bases, with a reduced C-Factor, significant differences were found between the light curing methods. For 6x2 base, with high C-Factor, the light curing method did not influence the contraction forces of the composite resin. CONCLUSIONS: Pulse delay technique can determine less stress on tooth/restoration interface of adhesive restorations only when a reduced C-Factor is present.

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

OBJECTIVES: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. MATERIAL AND METHODS: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T),Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2:1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were reanalyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (µm). Data were analyzed by ANOVA and Tukey's multiple-comparison test (α=0.05). RESULTS: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear ofnanofilled resins was significantly lower compared with microhybrid resins. CONCLUSIONS: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin

Adequate polymerization plays an important role on the longevity of the composite resin restorations. OBJECTIVES: The aim of this study was to evaluate the effect of light-curing units, curing mode techniques and storage media on sorption, solubility and biaxial flexural strength (BFS) of a composite resin. MATERIAL AND METHODS: Two hundred and forty specimens were made of one composite resin (Esthet-X) in a stainless steel mold (2 mm x 8 mm Ø), and divided into 24 groups (n=10) established according to the 4 study factors: light-curing units: quartz tungsten halogen (QTH) lamp and light-emitting diodes (LED); energy densities: 16 J/cm² and 20 J/cm²; curing modes: conventional (CM) and pulse-delay (PD); and permeants: deionized water and 75% ethanol for 28 days. Sorption and solubility tests were performed according to ISO 4049:2000 specifications. All specimens were then tested for BFS according to ASTM F394-78 specification. Data were analyzed by three-way ANOVA followed by Tukey, Kruskal-Wallis and Mann-Whitney tests (α=0.05). RESULTS: In general, no significant differences were found regarding sorption, solubility or BFS means for the light-curing units and curing modes (p>0.05). Only LED unit using 16 J/cm² and PD using 10 s produced higher sorption and solubility values than QTH. Otherwise, using CM (16 J/cm²), LED produced lower values of BFS than QTH (p<0.05). 75% ethanol permeant produced higher values of sorption and solubility and lower values of BFS than water (p<0.05). CONCLUSION: Ethanol storage media produced more damage on composite resin than water. In general the LED and QTH curing units using 16 and 20 J/cm² by CM and PD curing modes produced no influence on the sorption, solubility or BFS of the tested resin.

Seleção de cor e estratificação natural para reabilitação estética de dente anterior / Color selectiona and natural layering for aesthetic reproduction of anterior teetf

Em função da excelência em estética e desgaste mínimo da estrutura dentária, as resinas compostas ocupam uma posição de destaqque entre os materiais restauradores atuais. As novas resinas compsotas associadas ao melhor antendimento do comportamento dos tecidos dentários frente à incidência de luz permitem a estratificação natural dos dentes. A estratificação natural consiste em uma abordagem simples e efetiva para o emprego das resinas compostas nas restaurações, de modo a torná-las miméticas com a aparência natural do substrato dentário. Compreender e implementar princípios artísticos e científicos na escolha da cor dos materiais restauradores e a adequada inserção da resina composta, contudo, é imprescindível. Os passos operatórios para obter o sucesso restaurador com esse material serão descritos no relato do caso clínico.

Because of the excellence in aesthetics and minimal wear of the tooth structure, composite resins hold a prominent position among the current restorative materials. The new composite resins associated with better understanding of the behavior of dental tissues facing the incidence of light allows the natural stratification of teeth. This natural stratification consists of a simple and effective approach to the use of composite resins in restoration in order to make them mimetic with the natural appearance of the tooth substrate. Understanding and to implementing scientific and artistic principles in choosing the color of restorative materials and the proper insertion of the composite, however, is essential. The operative steps for success with this restorative material will be described in a clinical case report.

Tratamento da agenesia de incisivos laterais superiores: só Ortodontia basta? / Treatment of congenitally missing lateral incisors: Orthodontics is enough?

A ausência congênita de um ou mais dentes constitui uma anomalia de desenvolvimento nos humanos, com influência de fatores filogenéticos, sendo frequente nos incisivos laterais superiores, não obstante a agenesia dos terceiros molares apresentar a mais alta prevalência. Entretanto, do ponto de vista clínico, a ocorrência da falta de elementos dentários na região anterior implica em alteração morfofuncional, com comprometimento estético e, consequentemente, da harmonia do sorriso. A literatura odontológica tem evidenciado algumas opções de tratamento, destacando a contribuição da movimentação ortodôntica para o redimensionamento do espaço e adequação restauradora estética. Na grande maioria dos casos, a recomposição ou realinhamento dos dentes anteriores merece uma abordagem interdisciplinar, com associação de procedimento cirúrgico-restaurador. Para referenciar tal situação clínica, o presente trabalho tem por objetivo apresentar o tratamento de agenesia bilateral de incisivos laterais superiores, adotando-se uma abordagem ortodôntica inicial para promover fechamento de espaço na área edêntula, com concomitante abordagem periodontal e finalização do contexto estético e cosmético, por meio da reanatomização dos caninos e incisivos centrais.

Tratamiento de la pigmentación sistémica y la fluorosis por medio de blanqueamiento en consultorio asociado a microabrasión de esmalte / Treatment of systemic pigmentation and fluorosis through associated office bleaching enamel microabrasion

La resolución estética de los más diversos tipos de alteraciones de color de los dientes representa un gran desafío para el odontólogo. A través del correcto diagnóstico de estas alteraciones, el profesional puede decidir cuál es el mejor tratamiento estético u optar por la asociación de diferentes métodos de tratamiento a fin de alcanzar un resultado estético satisfactorio con un mínimo desgaste de las estructuras dentales. En la tentativa de promover mejoras en la estética de la sonrisa, el profesional puede usar el blanqueamiento dental en combinación con la microabrasión del esmalte como una opción segura y eficaz para la solución de algunas manchas. En el caso clínico presentado, las técnicas de blanqueamiento en consultorio con energía híbrida LASER/LED y la microabrasión del esmalte con pasta de ácido fosfórico 37% y piedra pómez fueron utilizadas para establecer un color armónico en los dientes que presentaban de pigmentación sistémica y fluorosis dental

The esthetic treatment of color alterations in dental organ meant a great challenge to the profession. By means of a comprehensive diagnostic, clinicians have to decide which the best esthetic solution is or to associate several methods in order to achieve a satisfactory esthetic treatment through a conservative approach. In an attempt to provide esthetic improvement, clinicians can combine bleaching and enamel microabrasion therapies as a safe and effective measure to solve dental staining. In this clinical case, bleaching at the dental office with hybrid LASER/LED energy and enamel microabrasion with 37% phosphoric acid and pumice paste were used to establish color harmony in teeth affected by systemic pigmentation and dental fluorosis

Aumento de la temperatura intracámara pulpar durante el blanqueamiento con sistemas activados por luz: revisión de la literatura / Temperature increase intracameral pulp during bleaching with light-activated systems: review of the literature

Son varias las fuentes de energía utilizadas para acelerar la descomposición del peróxido de hidrógeno durante el blanqueamiento realizado en el consultorio. Durante su aplicación, los sistemas de blanqueamiento dental que utilizan fuentes de energía, aumentan la temperatura de los tejidos dentarios. Existen evidencias de que el aumento de la temperatura intracámara pulpar puede causar daño a este tejido. Este trabajo tuvo por objetivo presentar a través de una revisión de la literatura los diferentes tipos de luz utilizados para blanqueamiento y el calentamiento intracámara pulpar generado por estos. El aumento de temperatura intracámara pulpar crítico es considerado de 5,5º C. En estudios in vitro varios son los sistemas y combinaciones de tiempo que llegan o pasan esta temperatura. Antes de la utilización de estos sistemas el odontólogo debe conocer los riesgos existentes y leer las instrucciones de los fabricantes

To accelerate the decomposition of hydrogen peroxide during the in-office bleaching process, various energy sources can be used. During the application of these energy systems, an increase of temperature in teeth tissue has been reported. The temperature rise in the pulp might be harmful to this tissue. The objective of this work was to present through a literature review the different lights for an in-office bleaching and the resultant intrapulpal temperature rise produced by these lights. The critical temperature rise in pulp chamber is considered to be 5.5º C. On in vitro studies there are many systems and time combinations that achieved or passed this critical limit. Before the use of any energy source for the in- office bleaching, the dentist should be concerned about the existing risk and must read the manufacturer's instructions

Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions

This controlled clinical trial evaluated the 2-year clinical performance of a one-bottle etch-and-rinse adhesive and resin composite system (Excite/Tetric Ceram) compared to a resin-modified glass ionomer cement (RMGIC) (Vitremer/3M) in non-carious cervical lesions. Seventy cervical restorations (35 resin composite - RC- restorations and 35 RMGIC restorations) were placed by a single operator in 30 patients under rubber dam isolation without mechanical preparation. All restorations were evaluated blindly by 2 independent examiners using the modified USPHS criteria at baseline, and after 6, 12 and 24 months. Data were analyzed statistically by Fisher's exact and McNemar tests. After 2 years, 59 out of 70 restorations were evaluated. As much as 78.8 percent retention rate was recorded for RC restorations, while 100 percent retention was obtained for RMGIC restorations. Fisher's exact test showed significant differences (p=0.011) for retention. However, there were no significant differences for marginal integrity, marginal discoloration, anatomic form and secondary caries between the RC and RMGIC restorations. The McNemar test detected significant differences for Excite/TC between baseline and the 2-year recall for retention (p=0.02), marginal integrity (p=0.002) and anatomic form (p=0.04). Therefore, the one-bottle etch-and-rinse bonding system/resin composite showed an inferior clinical performance compared to the RMGIC.

Esse estudo avaliou o desempenho clínico de restaurações de lesões cervicais não-cariosas por um período de 2 anos empregando um sistema adesivo de condicionamento total (Excite/Tetric Ceram) e um cimento de ionômero de vidro modificado por resina (Vitremer). Setenta restaurações (35 por material) foram realizadas por um único operador. Todas as lesões cervicais não-cariosas foram restauradas sem a execução de preparo cavitário e sob isolamento absoluto. As restaurações foram avaliadas por 2 examinadores independentes usando os critérios USPHS modificados nos períodos inicial, 6, 12 e 24 meses. A análise estatística foi realizada pelos testes de Fisher e McNemar. Cinquenta e nove restaurações foram avaliadas após 2 anos, obtendo-se um índice de retenção de 78,8 por cento para resina composta e 100 por cento para o cimento de ionômero de vidro modificado por resina. O teste exato de Fischer detectou diferença significante (p=0,011) para retenção entre os dois materiais. Contudo, não houve diferença significante para integridade marginal, descoloração marginal, forma anatômica e cárie secundária. O teste de McNemar detectou diferença estatística para o sistema Excite/Tetric Ceram entre o período inicial e 2 anos para os critérios de retenção (p=0,02), integridade marginal (p=0,002) e forma anatômica (p=0,04). Portanto, o sistema adesivo de condicionamento total apresentou um desempenho clínico inferior comparado ao cimento de ionômero de vidro modificado por resina.

Influence of pulse-delay curing on sorption and solubility of a composite resin

The purpose of this study was to evaluate the sorption and solubility of a composite resin (TPH³; Dentsply) cured with halogen light due to different storage media and curing modes. The methodology was based on the ISO 4049 standard. Two independent groups were established according to the storage time (7 days-G1; 60 days-G2). A stainless steel mould (2 mm x 8 mm Ø) was used. The selected curing modes were: I (Conventional - C): 40s - 600 mW/cm²; II (Pulse I - PD): 3 s - 200 mW/cm² + 2 min (delay) + 39 s - 600 mW/cm²; III (Pulse II): 10 s - 200 mW/cm² + 2 min (delay) + 37 s - 600 mW/cm²; IV (Pulse III): 3 s- 600 mW/cm² + 2 min (delay) + 37 s -600 mW/cm². The media used were: distilled water, 75 percent ethanol and 100 percent chlorophorm. Five repetitions were made for each group. The specimens were placed in a desiccator at 37ºC for 24 h and, after that, at 23ºC for 1 h to be weighed until a constant mass (m1) was obtained. The discs were immersed separately into the 3 media for 7 days (G1) and 60 days (G2), and thereafter reweighed (m2). The reconditioning in the desiccator was done until a constant mass (m3) was obtained. Sorption and solubility were calculated and the data of G1 and the sorption data of G2 were subjected to two-way ANOVA and Tukey's tests (p=0.05). The solubility data of G2 were analyzed by Kruskal-Wallis test (p=0.05). For G1 and G2, no statistically significant differences were found in sorption among curing techniques (p>0.05). The solubility values were negative, which means that there was mass gain. Regarding the storage media, in G2 chlorophorm had the highest sorption values. It may be concluded that the curing modes (C and PD I, II and III) did not affect the sorption of the tested composite resin. However, different storage media influenced sorption behavior. The solubility test demonstrated negative data, masking the real solubility.

Effect of light-curing units and activation mode on polymerization shrinkage and shrinkage stress of composite resins

The aim of this study was to evaluate the polymerization shrinkage and shrinkage stress of composites polymerized with a LED and a quartz tungsten halogen (QTH) light sources. The LED was used in a conventional mode (CM) and the QTH was used in both conventional and pulse-delay modes (PD). The composite resins used were Z100, A110, SureFil and Bisfil 2B (chemical-cured). Composite deformation upon polymerization was measured by the strain gauge method. The shrinkage stress was measured by photoelastic analysis. The polymerization shrinkage data were analyzed statistically using two-way ANOVA and Tukey test (p<0.05), and the stress data were analyzed by one-way ANOVA and Tukey's test (p<0.05). Shrinkage and stress means of Bisfil 2B were statistically significant lower than those of Z100, A110 and SureFil. In general, the PD mode reduced the contraction and the stress values when compared to CM. LED generated the same stress as QTH in conventional mode. Regardless of the activation mode, SureFil produced lower contraction and stress values than the other light-cured resins. Conversely, Z100 and A110 produced the greatest contraction and stress values. As expected, the chemically cured resin generated lower shrinkage and stress than the light-cured resins. In conclusion, The PD mode effectively decreased contraction stress for Z100 and A110. Development of stress in light-cured resins depended on the shrinkage value.

The effect of different light-curing units on tensile strength and microhardness of a composite resin

The aim of this study was to evaluate the influence of different light-curing units on the tensile bond strength and microhardness of a composite resin (Filtek Z250 - 3M/ESPE). Conventional halogen (Curing Light 2500 - 3M/ESPE; CL) and two blue light emitting diode curing units (Ultraled - Dabi/Atlante; UL; Ultrablue IS - DMC; UB3 and UB6) were selected for this study. Different light intensities (670, 130, 300, and 600 mW/cm², respectively) and different curing times (20s, 40s and 60s) were evaluated. Knoop microhardness test was performed in the area corresponding to the fractured region of the specimen. A total of 12 groups (n=10) were established and the specimens were prepared using a stainless steel mold composed by two similar parts that contained a cone-shaped hole with two diameters (8.0 mm and 5.0 mm) and thickness of 1.0 mm. Next, the specimens were loaded in tensile strength until fracture in a universal testing machine at a crosshead speed of 0.5 mm/min and a 50 kg load cell. For the microhardness test, the same matrix was used to fabricate the specimens (12 groups; n=5). Microhardness was determined on the surfaces that were not exposed to the light source, using a Shimadzu HMV-2 Microhardness Tester at a static load of 50 g for 30 seconds. Data were analyzed statistically by two-way ANOVA and Tukey's test (p<0.05). Regarding the individual performance of the light-curing units, there was similarity in tensile strength with 20-s and 40-s exposure times and higher tensile strength when a 60-s light-activation time was used. Regarding microhardness, the halogen lamp had higher results when compared to the LED units. For all light-curing units, the variation of light-exposure time did not affect composite microhardness. However, lower irradiances needed longer light-activation times to produce similar effect as that obtained with high-irradiance light-curing sources.

Volumetric polymerization shrinkage of contemporary composite resins

The polymerization shrinkage of composite resins may affect negatively the clinical outcome of the restoration. Extensive research has been carried out to develop new formulations of composite resins in order to provide good handling characteristics and some dimensional stability during polymerization. The purpose of this study was to analyze, in vitro, the magnitude of the volumetric polymerization shrinkage of 7 contemporary composite resins (Definite, Suprafill, SureFil, Filtek Z250, Fill Magic, Alert, and Solitaire) to determine whether there are differences among these materials. The tests were conducted with precision of 0.1 mg. The volumetric shrinkage was measured by hydrostatic weighing before and after polymerization and calculated by known mathematical equations. One-way ANOVA (ß=0.05) was used to determine statistically significant differences in volumetric shrinkage among the tested composite resins. Suprafill (1.87±0.01) and Definite (1.89±0.01) shrank significantly less than the other composite resins. SureFil (2.01±0.06), Filtek Z250 (1.99±0.03), and Fill Magic (2.02±0.02) presented intermediate levels of polymerization shrinkage. Alert and Solitaire presented the highest degree of polymerization shrinkage. Knowing the polymerization shrinkage rates of the commercially available composite resins, the dentist would be able to choose between using composite resins with lower polymerization shrinkage rates or adopting technical or operational procedures to minimize the adverse effects deriving from resin contraction during light-activation.

Sistemas adesivos simplificados e resinas compostas: avaliação da compatibilidade de união / Simplified adhesive systems and composite resins: bond compatibility evaluation

Objetivos: Avaliar a compatibilidade de união pela interação dos adesivos Single Bond (3M), Prime-Bond 2.1 (Dentsply) e Excite (Ivoclar/Vivadent) com as resinas compostas Z100 (3M), Esthet-X (Dentsply) e Tetric Ceram (Ivoclar/Vivadent), por meio do teste de resistência à tração. Métodos: Utilizou-se um conjunto de matrizes de aço inoxidável, composto de duas partes, sendo que cada parte apresentava um orifício central cônico com 8mm de diâmetro maior, 5mm de diâmetro menor e 1 mm de espessura. Uma das partes da matriz foi preenchida com uma das resinas compostas e fotoativada por 20s, aplicando-se uma camada de um dos sistemas adesivos na área de união e subseqüente fotoativação, por 20s. A segunda parte da matriz foi posicionada sobre a primeira inserindo o material de acordo com passos descritos para a primeira porção. Foram estabelecidos nove grupos, no total de 45 corpos de prova, sendo cinco espécimes para cada grupo experimental. Após uma hora, os corpos de prova foram submetidos ao teste de tração na máquina de ensaios Kratos. Resultados: Os resultados de união, em Kgf/cm2, entre a resina Esthet-X com os adesivos Single Bond, Prime-Bond 2.1 e Excite foram: 12.34, 12.00 e 9.80; da resina Tetric Ceram: 8.82, 10.91 e 8.05; da resina Z100, 11.44, 11.40 e 8.99, respectivamente. Conclusão: A análise estatística de variância a dois critérios não mostrou diferença significante nas interações dos adesivos simplificados com as diferentes resinas compostas, evidenciando que a compatibilidade química entre eles constitui uma alternativa viável na prática restauradora.

Effect of storage period on the accuracy of elastomeric impressions

AIMS: To investigate the effect of the storage period on the accuracy of recently developed elastomeric materials. METHODS: Simultaneous impressions of a steel die were taken using a polyether (I: Impregum Soft Heavy and Light body, 3M ESPE) and vinyl polysiloxane (P: Perfectim Blue Velvet and Flexi-Velvet, J.Morita). The trays were loaded with the heavy-bodied impression materials while the light-bodied impression materials were simultaneously spread on the steel die. The impressions were poured after 2 hours, 24 hours, and 7 days. Impressions were stored at approximately 55 percent relative humidity and room temperature. Ten replicas were produced for each experimental condition (n=60). Accuracy of the stone dies was assessed with a depth-measuring microscope. The difference in height between the surface of the stone die and a standard metallic ring was recorded in micrometers at four demarcated points, by two independent examiners. Data were submitted to two-way ANOVA and Tukey test (a = 0.05). RESULTS: Significant differences were found among the groups. Smaller discrepancies were observed when pouring was performed up to 24 hours (I-2h= 65.0 ± 15.68 µm; I-24h= 81.6 ± 11.13 µm) for the polyether, and up to 7 days for the vinyl polysiloxane (P-2h= 79.1 ± 13.82 µm; P-24h= 96.8 ± 6.02 µm; P-7d= 81.4 ± 4.3 µm). Significant dimensional discrepancies, however, were observed when polyether was stored for 7 days (I-7d= 295.3 ± 17.4 µm). CONCLUSION: Storage may significantly affect the dimensional accuracy of impressions and, thus, a maximum period and storage condition should be specified for the recently developed materials.