Restauração indireta em resina composta: um relato de prontuário / Indirect resin composite restoration: a dental record report

Restaurações diretas em resina composta são amplamente utilizadas em odontologia para restaurar dentes posteriores. Todavia, quando há grande destruição coronária, onde a distância do istmo excede dois terços da distância intercuspídea, as restaurações indiretas em resina composta são indicadas. O presente estudo teve como objetivo relatar a análise de um prontuário de um paciente que recebeu uma restauração indireta em resina composta em dente posterior amplamente destruído. Através da análise de prontuários de pacientes atendidos nas disciplinas de Estágios Supervisionados do Curso de Odontologia da FSG Centro Universitário no ano de 2023, foi selecionado um prontuário de um paciente que compareceu a clínica odontológica da FSG com uma restauração em amálgama fraturada com reparo em resina composta que apresentou sintomatologia dolorosa. O procedimento diagnóstico ocorreu através de exame clínico e radiográfico, que constatou a indicação de substituição da restauração insatisfatória e realização de uma restauração indireta em resina composta. Os resultados estéticos e funcionais apresentados demostraram a viabilidade da técnica restauradora indireta em resina composta para reabilitar dentes posteriores com ampla destruição coronária(AU)

Direct composite resin restoration are widely used in dentistry to restore posterior teeth. However, when there is large coronary destruction, that the distance from the isthmus exceeds two- thirds of the intercuspal distance, indirect composite resin restorations are indicated. This study aimed to report the analysis of a dental record of a patient who received an indirect restoration in composite resin in a badly destroyed posterior tooth. Through the analysis of dental records of patients seen in the disciplines of Supervised Internship of the Dentistry Course at FSG Centro Universitário in the year 2023, the dental record of a patient who attended the FSG dental clinic with fractured amalgam restoration with composite resin repair was selected who had painful symptoms. The diagnostic procedure took place through clinical and radiographic examination, which revealed the indication of replacing the unsatisfactory restoration and carrying out an indirect restoration in composite resin.The aesthetic and functional results presented demonstrated the viability of the indirect composite resin restoration technique for rehabilitating posterior teeth with extensive coronal destruction(AU)

Modificação de uma resina composta Bulk Fill Flow com extrato acetônico da casca da romã / Modification of a Bulk Fill Flow composite resin with acetonic extract from pomegranate peel

Introdução: A cárie dentária ainda se constitui um problema de saúde pública. Áreas adjacentes a restaurações são frequentemente acometidas por cárie. Por mais que as resinas compostas estejam sendo estudadas e melhoradas, ainda não apresentam atividade antimicrobiana. As cascas da romã (Punica Granatum) são um recurso potencial para compostos bioativos como fenólicos, proantocianidinas e flavonoides, além de apresentarem atividade antioxidante e efeito inibitório contra bactérias Gram-negativas e Gram-positivas. Objetivo: modificar a resina composta Opus Bulk Fill Flow (FGM®) com o extrato acetônico da casca da romã em diferentes concentrações e avaliar a rugosidade da superfície e mudança de cor. Metodologia: foi realizada a extração de 5g de casca da romã utilizando 100mL de solvente acetona 70%. Após rotaevaporação, filtragem e liofilização do extrato, este foi macerado, peneirado e pesado em concentrações diferentes a partir da concentração inibitória mínima capaz de inibir o crescimento de Streptococcus mutans ATCC 700610. A resina composta Opus Bulk Fill Flow foi modificada com esse extrato em diferentes concentrações de forma a gerar 5 grupos: Controle 0 µg (n=10), G930 µg (n=10), G1860 µg (n=10), G3730 µg (n=10) e G7460 µg (n=10). Rugosidade (Ra), diferença de cor (ΔE00) e índice de brancura (WID) foram submetidos aos testes de normalidade. Os dados não-paramétricos de Ra foram submetidos ao teste de Kruskal-Wallis com pós-teste de Dunn e os dados paramétricos do ΔE00 e WID foram submetidos ao teste ANOVA 1 Fator com pósteste de Tukey por meio do software GraphPad Prism 8 e Microsoft Excel 2019. Resultados: Verificou-se que a média do índice de brancura (WID) diminuiu conforme o aumento da concentração do extrato na resina modificada (p<0,05), assim como, as resinas modificadas se tornaram, visivelmente a olho nu, um pouco mais amareladas. Após 1 mês, as amostras dos grupos experimentais sofreram a mesma variação de cor (ΔE00) que o grupo controle, uma vez que os valores das médias foram semelhantes. Portanto, todos os grupos apresentaram estabilidade de cor. A rugosidade superficial (Ra) não mostrou diferença estatisticamente significativa (p>0,05). Todos os grupos apresentaram médias com valores similares a 0,06µm. Conclusão: A alteração de cor na resina, com a inserção do extrato, ainda na maior concentração, se manteve na classificação do matiz A. O que não afeta as propriedades organolépticas e pode ser considerada uma cor similar à cor dos dentes naturais. A adição do extrato na resina manteve a rugosidade superficial de todos os grupos dentro do valor ideal, prevenindo a adesão de biofilmes e microrganismos e proporcionando conforto ao toque da língua (AU).

Introduction: Dental caries still constitutes a public health problem. Areas adjacent to restorations are often affected by caries. Even though resin composites are being studied and improved, they still do not have antimicrobial activity. Pomegranate peels (Punica Granatum) are a potential resource for bioactive compounds such as phenolics, proanthocyanidins and flavonoids, in addition to presenting antioxidant activity and inhibitory effects against Gram-negative and Gram-positive bacteria. Objective: to modify the Opus Bulk Fill Flow (FGM™) resin composite with the acetone extract of pomegranate peel in different concentrations and evaluate the surface roughness, and color change. Methodology: 5g of pomegranate peel was extracted using 100mL of 70% acetone solvent. After rotary evaporation, filtering and lyophilization of the extract, it was macerated, sieved and weighed at different concentrations based on the minimum inhibitory concentration capable of inhibiting the growth of Streptococcus mutans ATCC 700610. The Opus Bulk Fill Flow resin composite was modified with this extract in different concentrations to generate 5 groups: Control 0 µg (n=10), G930 µg (n=10), G1860 µg (n=10), G3730 µg (n=10) e G7460 µg (n=10). Roughness (Ra) and color difference (ΔE00) were subjected to normality tests and non-parametric data were subjected to the Kruskal-Wallis test with Dunn's post-test using GraphPad Prism 8 and Microsoft Excel 2019 software. Results: It was found that the average whiteness index (WID) decreased as the concentration of the extract in the modified resin increased (p<0.05), as well as the modified resins became, visibly to the naked eye, a little more yellowish. After 1 month, samples from the experimental groups suffered the same color variation (ΔE00) as the control group, since the average values were similar. Therefore, all groups showed color stability. Surface roughness (Ra) did not show a statistically significant difference (p>0.05). All groups presented average values similar to 0.06µm. Conclusion: The color change in the resin, with the insertion of the extract, even at the highest concentration, remained in the classification of hue A. This does not affect the organoleptic properties and can be considered a color similar to the color of natural teeth. The addition of the extract to the resin composite maintained the surface roughness of all groups within the ideal value, preventing the adhesion of biofilms and microorganisms and providing comfort to the touch of the tongue (AU).

Influence of different opacities and layering technique of nanotechnology composite resins regarding the wavelength and fluorescence intensity: in vitro study / Influencia de diferentes opacidades y la técnica de estratificación de resinas compuestas de nanotecnología en la longitud de onda e intensidad de fluorescencia: estudio in vitro

Objective: To evaluate the influence of opacity and the layering technique on the fluorescence of different composite resins. Materials and Methods: Two opacities (enamel and dentin) and the layering technique (enamel + dentin) of the composite resins: Filtek® Z350 and Palfique LX5 were evaluated in vitro. Composite resin discs were fabricated using a preformed matrix of 10 mm diameter and 0.5 mm thick for the single opacity groups and 10 mm thick for the layering technique groups, using 2 layers of 0.5 mm thickness of each opacity (n = 5). Specimens were analyzed using the Raman spectroscopy method. Data were analyzed using the Kruskall-wallis and Mann-Whitney U tests. Results: When evaluating the intensity of fluorescence, no statistically significant difference was found when comparing the layering technique and enamel opacity (p2> 0.05) and an increase in the dentin opacity value for both brands of composite resin. Regarding wavelength, no statistically significant difference was found when comparing the layering technique with enamel opacity and dentin opacity for both Filtek® Z350 and Palfique LX5® composite resins (p2 > 0.05). Conclusions: The fluorescence intensity of the layering technique is similar to enamel opacity for both composite resins. Likewise, the wavelength of the layering technique is similar to the enamel opacity and dentin opacity for both brands.

Objetive: Evaluar la influencia de la opacidad y de la técnica de estratificación en la fluorescencia de diferentes resinas compuestas. Materiales y Métodos: Se evaluó in vitro 2 opacidades (Esmalte y Dentina) y la técnica de estratificación (Esmalte + Dentina) de las resinas compuestas: Filtek® Z350 y Palfique LX5. Se fabricaron discos de resina compuesta, utilizando una matriz preformada de 10 mm de diámetro y 0,5 mm de grosor para los grupos de opacidad única y 10 mm de grosor para los grupos de técnica estratificada, utilizando 2 capas de 0,5 mm de cada opacidad (n = 5). Los especímenes se analizaron mediante el método de Espectroscopía Raman. Los datos se analizaron utilizando la prueba de Kruskall-wallis y Prueba U de Mann Whitney. Resultado: Al evaluar la intensidad de fluorescencia no se encontró diferencia estadísticamente significativa entre los pares: Técnica estratificada versus Opacidad Esmalte para ambas marcas de resina compuesta Filtek® Z350 y para Palfique LX5® (p2 > 0,05). Para longitud de onda no se encontró diferencia estadísticamente significativa entre los pares: Técnica estratificada versus Opacidad Esmalte y Técnica estratificada VS Opacidad Dentina para ambas resinas compuesta Filtek® Z350 y Palfique LX5® (p2> 0,05). Conclusión: La intensidad de fluorescencia de la técnica estratificada es similar a la opacidad Esmalte para ambas resinas compuestas. De igual manera la longitud de onda de la técnica estratificada es similar a la opacidad Esmalte y opacidad Dentina para ambas marcas.

Reanatomização estética dos dentes anteriores com resina composta: relato de caso / Reanatomización estética de dientes anteriores com resina compuesta: reporte de caso / Aesthetic reanatomization of front teeths with composite resin: case report

Introdução: A alta busca por tratamentos estéticos levou a indústria odontológica a aprimorar suas técnicas e desenvolver materiais com novas características que possibilitam a mimetização da estrutura dental, associando alta qualidade estética à saúde. Para isso, é necessário uma anamnese detalhada e exame físico intra e extrabucal, análise morfológica dos dentes e da face, para que a reabilitação proposta seja adequada. Objetivo: O objetivo deste estudo é descrever um caso clínico de reanatomização dos elementos dentais anteriores superiores, por meio de restaurações diretas em resina composta, restabelecendo a estética e função da paciente. Relato de caso: Paciente do sexo feminino, 19 anos, procurou a Clínica Escola da Faculdade de Odontologia do Recife -FOR relatando insatisfação com seu sorriso e declarou não estar disposta a se submeter a um tratamento ortodôntico. Ao realizar o exame clínico, observou-se que havia desalinhamento dos elementos dentários ântero-superiores. Após a realização do enceramento diagnóstico e validação da mesma através do mockupcom resina bisacrílica, optou-se por realizar a reanatomização estética com resina composta nanohíbrida, de forma conservadora, ou seja, sem desgastar os dentes em questão. Conclusão: As etapas do planejamento foram fundamentais para maior previsibilidade e obtenção do excelente resultado. Os materiais e técnicas selecionados para realização dos procedimentos aliaram características de resistência e estética, visando maior longevidade (AU).

Introduction: The high demand for aesthetic treatments has led the dental industry to improve its techniques and develop materials with new characteristics that allow mimicking the tooth structure, associating high aesthetic quality with health. This requires a detailed anamnesis,intra-and extraoral physical examination, and morphological analysis of the teeth and faceto allow an adequate proposed rehabilitation. Objective:The objective of this study is to describe a clinical case of reshaping of upper anterior teeth, by direct composite resin restorations, reestablishing the patient's aesthetics and function. Case report:Female patient, 19 years old, sought the Clínica Escola da Faculdade de Odontologia do Recife -FOR, reporting dissatisfaction with her smile and declared that she was unwilling to undergo orthodontic treatment. Clinical examinationrevealed misalignment of the upper anteriorteeth. After diagnostic waxing and validation by mockup with bis-acryl resin, it was decided to perform the aesthetic reshaping with nanohybrid composite resin in a conservative manner, i.e., without tooth wearing . Conclusion:The planning stages were fundamental for greater predictability and obtaining excellent results. The materials and techniques selected for the procedurescombined resistance and aesthetic characteristics, aiming at greater longevity (AU).

Introducción:La gran demanda para tratamientos estéticos ha llevado a la industria dental a mejorarsus técnicas y desarrollar materiales con nuevas características que permitan mimetizar la estructura dental, combinando una alta calidad estética con la salud. Para que esto ocurra, es necesario realizer una anamnesis detallada y un examen físicointra y extraoral, así como un análisis morfológico de los dientes y de la cara, para que la rehabilitación propuesta sea da adecuada. Objetivo:El objetivo de este studio es describir un caso clínico de reanatomización de los elementos dentales de resinacompuesta, restabeleciendo la estética y función de la paciente. Informe de caso:Paciente del sexo feminine, 19 años de edad, que acudió a la Clínica Escuela de La Facultad de Odontología de Recife ­FOR menifestando insatisfaccíon con su sonrisa y declarando no estar dispuesta a someterse a tratamiento de ortodoncia. En el examen clínico se observódesalineación de los elementos dentarios anterosuperiores. Tras realizar un encerado diagnóstico y validarlo con un mock-up de resina bisacrílica, se optó porrealizer una reanatomización estética con resina compuesta nanohíbrida de forma conservadora, es decir, sin desgastarlos dientes implicados. Conclusión:Las etapas de planificacíon han sido fundamentales para una mayor previsibilidad y la obtención de excelentes resultados. Los materiales y técnicas seleccionados para la realización de los procedimentos combinaron características de resistencia y estética, buscando una mayor longevidad (AU).

Mathematical-Physical description of the oxygen-inhibited layer (OIL) in nanofilled dental polymers / Descripción físico-matemática de la capa inhibida por oxígeno en polímeros dentales nano rellenados

Abstract This research evaluates the presence of the oxygen-inhibited layer (OIL) on the top surface of a photopolymerized dental composite resin protected with a glycerin layer. This evaluation was conducted using physical and mathematical methods. Polymerized discs were fabricated to evaluate Vickers microhardness (VHN), and pre-and post-polymerized samples were used for the calculation of C-O/C-H ratios through Fourier Transform Infrared Spectroscopy (FTIR) (n=10), using two types of glycerin, one for medical use (MG) and another for dental use (DG). Surface hardness decreased from MG to DG to CO, and the increase in C-O/C-H ratios decreased in the same order (p<0.05). Samples protected with medical and dental glycerin layers are harder and exhibit lower C-O/C-H bond ratios than the control group.

Resumen La presente investigación evalúa la presencia de la capa inhibida por oxígeno OIL en la última superficie fotocurada de una resina compuesta de uso odontológica que fue protegida con una capa de glicerina. Esta evaluación se hizo a partir de métodos físicos y matemáticos. Se fabricaron discos polimerizados para evaluar la microdureza Vickers (VHN) y pre y post polimerizados para el cálculo de tasas C-O/C-H por medio de Espectroscopía Infrarroja Transformada de Fourier (FTIR) (n=10) usando dos tipos de glicerina, una de uso médico (MG) y otra de uso dental (DG). La dureza superficial disminuyó de MG a DG a CO y el aumento de tasas C-O/C-H disminuyó en ese mismo orden (p<0,05). Las muestras protegidas con capas de glicerina médica y odontológica son más duras y presentan menos cantidad tasas de enlaces C-O/C-H que el grupo control.

Indicaciones y contraindicaciones de los selladores de fosas y fisuras en pacientes adultos / Indications and contraindications of pit and fissure sealants in adult patients

El objetivo de la odontología preventiva es reducir al máximo el riesgo de desarrollar enfermedades bucodentales; para lograrlo, existen múltiples métodos como la aplicación de flúor, así como la colocación de selladores de fosas y fisuras. Los selladores son materiales resinosos capaces de cubrir y eliminar las retenciones de las fosas y fisuras características de la anatomía oclusal. Si bien los selladores son ampliamente utilizados en pacientes pediátricos, erróneamente se cree que su colocación está contraindicada en adultos. Los selladores son métodos preventivos capaces de beneficiar a cualquier paciente que los necesite, independientemente de su edad. El objetivo de este artículo es analizar y esclarecer las indicaciones y contraindicaciones de los selladores de fosas y fisuras en pacientes adultos (AU)

The objective of preventive dentistry is to minimize the risk of developing oral diseases and to achieve this there are multiple methods such as the application of fluoride, as well as the placement of pit and fissure sealants. Sealants are resinous materials capable of covering and eliminating retentions in pits and fissures characteristic of occlusal anatomy. Although sealants are widely used in pediatric patients, it is erroneously believed that their placement is contraindicated in adult patients. Sealants are preventive methods capable to benefiting any patient who needs them regardless of age. The aim of this article is to analyze and clarify the indications and contraindications of pit and fissure sealants in adult patients (AU)

Influencia del termociclado sobre la estabilidad del color de dos resinas compuestas / Influence of thermocycling on the color stability of two composite resins

Objetivo: Cuando las resinas compuestas son expuestas a procesos de envejecimiento naturales en boca, como es el ciclaje térmico, pueden sufrir un deterioro en sus propiedades ópticas. El objetivo de este estudio fue evaluar la influencia del envejecimiento térmico sobre la estabilidad del color de dos resinas compuestas. Materiales y métodos: Se confeccionaron 120 pas- tillas de resinas compuestas, divididas en dos grupos: uno de resina Spectra Smart (n=60) y otro de resina Filtex Z350 XT (n=60). Estas muestras fueron sometidas a distintos regíme- nes de ciclaje térmico de 0, 10.000, 20.000 y 30.000 ciclos con temperaturas de entre 5 ºC +/- 2 ºC y 55 ºC +/- 2 °C. Los parámetros de color CIE L*a*b* de cada muestra se mi- dieron con un espectrofotómetro antes y después del proceso de envejecimiento. Las diferencias de color se calcularon me- diante la fórmula CIELAB (ΔE). Los datos fueron analizados estadísticamente usando la prueba no paramétrica de Kruskal Wallis y de U-Mann Whitney. Resultados: Los distintos regímenes de termociclado produjeron cambios de color estadísticamente significativos en ambos materiales. El material que tuvo menor estabilidad cromática fue Spectra Smart aunque sin diferencias estadísti- camente significativas. Conclusión: El envejecimiento térmico simulado a tres años afecta la estabilidad de color de las muestras, tanto de las resinas Spectra Smart, como de Filtex Z350 XT, sin alcanzar los valores que clínicamente determinarían la necesidad del reemplazo de las restauraciones (AU)

Aim: When composite resins are exposed to natural ag- ing processes in the mouth, such as the thermal cycling, they may suffer a deterioration in their optical properties. The aim of this study was to evaluate the influence of thermal aging on the color stability of two composite resins. Materials and methods: 120 composite resins tablets were made, divided into two groups: one of Spectra Smart res- in (n=60) and another of Filtex Z350 XT resin (n=60). These were subjected to different thermal cycle regimes of 0, 10,000, 20,000 and 30,000 cycles with temperature between 5 °C +/- 2 °C and 60 °C +/- 2 °C. The CIE L*a*b* color parameters of each sample were measured with a spectrophotometer before and after the aging process. Color differences were calculat- ed using the CIELAB formula (ΔE). The data were statisti- cally analyzed using the non-parametric Kruskal Wallis and U-Mann Whitney tests. Results: The different thermocycling regimes produce statistically significant color changes in both materials. The material that had the least chromatic stability was Spectra Smart, although without statistically significant differences. Conclusion: Simulated 3 year thermal aging affects the color stability of the samples, both Spectra Smart resins and Filtex Z350 XT, without reaching the values that would clini- cally determine the need to replace the restorations (AU)

Effect of Water and Chlorhexidine with Different Pressures of Oral Irrigation Device on the Surface Roughness and Topography of Giomer

Abstract Objective: To evaluate the effect of different pressures of an oral irrigation device (OID) and the irrigation solution type on the surface roughness of the giomer restorative material. Material and Methods: In this in vitro study, disk-shaped giomer samples were fabricated and assigned to 5 groups (n=23): Group 1, storage in distilled water (control); Group 2, OID #7 pressure/ water; Group 3, OID #10 pressure/ water; Group 4, OID #7 pressure/ 0.05% CHX; Group 5, OID #10 pressure/ 0.05% CHX. The samples' treatment simulated a one-year application of OID. Surface roughness (Ra) and topography of the giomer were evaluated using profilometry and scanning electron microscopy. The data were analyzed with Paired t-test, Tukey, and ANOVA tests (α=0.05). Results: The Ra of the samples increased significantly after treatment with OID (p<0.001). The roughness increase in groups with a pressure of 10 was higher than those with a pressure of 7 (p<0.001). The effect of pressure on surface changes was significant (p<0.001). However, the solution type and the cumulative effect of these two factors were insignificant (p=0.08 and p=0.43, respectively). Conclusion: Oral irrigation device with both solutions significantly increased the surface roughness and topographic changes of the giomer. The severity of these changes was related to the device's pressure.

The Effect of Restoration Polymerization and Residual Dentine Thickness on Thermal Changes of Pulp Chamber of Immature Permanent Teeth

ABSTRACT Objective: To evaluate the pulpal temperature changes due to the polymerisation of resin and glass ionomer-based materials in dentine thicknesses in immature permanent teeth with open apices. Material and Methods: Forty extracted sound human third molar teeth with open apices were included. The width of the cavities prepared on the occlusal surface was 4×5 mm. The depth was 2 mm in the resin groups. 4 mm in the groups in which glass ionomer liner was applied before composite restoration. The coronal parts of the samples were then placed on an acrylic plate with three gaps for feeding-extraction needles and the thermocouple. The temperature changes were recorded. The data was analyzed by SPSS. Statistical significance was accepted as p<0.05. Results: The temperature increase in the group of 1 mm remaining dentin thickness revealed higher results than the values detected from the 2 mm group (1.01 °C) (p=0.00). The mean values (1.49 °C, 1mm) of temperature changes in only glass ionomer applied group were lower than the avarage values (2.210°C, 1mm) determined in the polymerization process of resin composites with light-emitting diode devices. Conclusion: In a remaining dentin thickness of 1 mm in teeth with open apices, using a glass ionomer liner might be a useful effort for protecting the pulp from the heat generated by polymerisation devices.

Does the combination of whitening toothpaste and hydrogen peroxide bleaching increase the surface roughness and change the morphology of a nanofilled composite?

Aim: To evaluate changes in the surface roughness and morphology of a nanofilled composite following toothbrushing with a whitening (WT) or regular toothpaste (RT), alone or combined with 35% hydrogen peroxide bleaching (HP). Methods: Seventy disc-shaped nanofilled composite (Filtek Z350XT) specimens were randomly divided into groups (n=10): WT, RT, TB (without toothpaste ­ control) or the combinations WT/ HP, RT/HP, TB/HP and HP. All groups underwent toothbrushing simulation (60,000 cycles) and bleaching treatment (4 sessions). Mean surface roughness (Ra, µm) was measured before (T0) and after treatments (TB). Surface morphology was assessed by scanning electron microscopy (SEM) at TB. Mean Ra was analyzed using general mixed models and multiple comparisons by the Tukey-Kramer test (α=5%). Results: HP caused no surface roughness changes on the nanofilled composite after treatment (p>0.05). RT toothbrushing, combined or not with HP, increased the surface roughness (p<0.05). WT and WT/ HP protocols had no effect on the surface roughness of the composite (p>0.05). The nanofilled composite submitted to RT toothbrushing combined with HP (RT/HP) presented substantial surface alterations under SEM, showing deep depressions and round-shaped defects. Toothbrushing with RT combined with the bleaching agent increased exposure of the inorganic fillers. Conclusion: WT toothbrushing, regardless of HP combination, or the single HP protocol had no effect on the surface roughness of the nanofilled composite. However, RT combined with HP negatively affected surface roughness and presented the most noticeable surface changes among groups

Color variation of composite resins in relation to the Vita Classical shade guide: colorimetric analysis

Aim: The aim of this study was to verify the color variation between different composite resins and the Vita Classical Shade Guide. Methods: Two-millimeter thickness samples were made (n = 6) from eight commercial brands of composite resin (shade A2): Charisma (Kulzer), Forma (Ultradent), Harmonize (Kerr), Luna (SDI), Opallis (FGM), Oppus Bulk Fill (FGM), Vittra (FGM) and Filtek Z250 XT (3M ESPE). Specimens were stored in distilled water for 7 days and then polished. Color measurements of samples and A2 shade of the Vita Classical Shade Guide were performed using the Vita Easy Shade Advance 4.0 spectrophotometer on a black background. Color variations were calculated using the CIEDE2000 formula, considering values ≥0.81 being noticeable by the human eye and ≥1.77 being clinically unacceptable. Results were statistically analyzed with a 5% significance level. Results: Color variation (ΔE) of composite (E1 ) compared to the Vita Classical Shade Guide (E0 ) was greater than clinically acceptable for all the materials evaluated in this study. Forma (ΔE=2.08 ± sd=0.47) and Filtek Z250 XT (2.50 ± 0.20) had the smallest amount of color variation values found in the results. Harmonize (3.32 ± 0.63) presented values similar to Filtek Z250 XT, but it was worse than Forma. Vittra (3.51 ± 0.28), Charisma (3.80 ± 0.20), Opallis (4.24 ± 0.30) and Luna (5.67 ± 0.20) did not differ among each other and presented higher color variation than Forma, Filtek Z350XT and Harmonize. Oppus Bulk Fill (13.94 ± 1.12) was the composite with the greatest color variation. Conclusions: The findings in this study show that attention should be taken when using the Vita Color Shade Guide for composite shade selection

Assessment of bulk-fill of resins microhardness longitudinal

Aim: This study aimed to assess the polymerization effectiveness of bulk-fill composite resins in longitudinal microhardness. Methods: Blocks of bulk-fill composite resin with thicknesses of 6 mm were analyzed with Vickers microhardness. The resin blocks were divided into two groups (n=6): resin AURA and OPUS. The microhardness test was performed before (base and top) and after (longitudinal microhardness) sectioning the blocks at distances of 2 mm, 4 mm, and 6 mm from the top of the block. The mean microhardness values were tabulated and subjected to ANOVA followed by Tukey's test (p<0.05). Results: The OPUS bulk-fill resin samples presented microhardness means of 55.9 kgf/mm2, 53.7 kgf/mm2, and 49.3 kgf/mm2, the AURA bulk-fill resin samples presented microhardness means of 57,02 kgf/mm2, 55,86 kgf/mm2 e 51,77 kgf/mm2 for the distances of 2 mm, 4 mm, and 6 mm, respectively. Tukey's statistical test showed a significant difference in microhardness values at different distances of 2 mm, 4 mm, and 6 mm (p<0.001) for each resin. Although there was a statistically significant difference within and between the groups assessed, all samples showed polymerization effectiveness when comparing the top and base of the block. Conclusion: Polymerization was effective in different thicknesses (2 mm, 4 mm, and 6 mm) in both resins studied. The microhardness ratio was adequate when comparing the base and top

The "Phase Down" of Dental Amalgam Restorations - What are the Criteria for Replacement and Indication?

ABSTRACT Objective: To guide professionals about the criteria for replacing amalgam restorations and inform them about the new guidelines regarding the use/indication of this (amalgam) material after the Minamata Convention - COP-4. Material and Methods: The articles were selected from the databases (PubMed, Scielo, Bireme), and relevant articles on the subject between the years 2003-2021 were selected. Recently, social media have been flooded with dental treatments that aim to perform restorations only with composite resins or other types of esthetic material and completely replace all dental amalgam restorations, irrespective of their time in place, size, and functionality. Results: Although improperly, it has been noted that this information reaches patients, and they are led to believe in the inaccurate data that is passed on, such as, for example, (that amalgam leads to) permanent contamination by mercury, causing systemic problems and the loss of the tooth. Conclusion: The "phase down" of amalgam in research and teaching has previously been observed in several countries worldwide; however, its use is still necessary given particular circumstances, which, theoretically, make it a material with exact indication.

Effect of Toothpaste Fluoride Concentration on Color Stability of Resin Composites: An In Vitro Study

ABSTRACT Objective: To investigate the effects of two different dentifrice fluoride concentrations on the color stability of the composite. Material and Methods: Twenty-seven specimens (2×4×5 mm) each of microfilled (Gradia, GC, Japan) and nanohybrid (Grandio, VOCO, Germany) composites were prepared. The specimens were randomly divided into six groups (control, Fluoflor caries protection toothpaste with 1450ppm Fluoride (EXW, France), and Fluoflor kids toothpaste with 500ppm Fluoride (EXW, France) (n = 9). The specimens were immersed in a mixture of artificial saliva and toothpaste in a ratio of 1:3 and applied for 60 seconds every 12 hours for 42 days. The control samples were incubated in artificial saliva at 37°C. Primary and secondary color measurements were performed using color parameters (L∗a∗b) with a spectrophotoshade (MHT Optic Research AG, Niederhasli, Switzerland). Data were analyzed using a two-way analysis of variance at a significance level of 0.05. Results: According to the two-way ANOVA analysis, there was no significant difference in color change between the composites and no difference in the level of discoloration between different fluoride concentrations(p>0.05). Also, None of the dentifrices caused clinically significant color changes(∆E˂3.3). Conclusion: No clinically unacceptable color changes were observed in the microfilled and nanofilled composites with different concentrations of fluoride toothpaste.

Color and surface roughness alterations of bulk-fill resin composites submitted to simulated toothbrushing with whitening dentifrices

Aim: To evaluate the surface roughness and color stability of bulk-fill resin composites after simulated toothbrushing with whitening dentifrices. The radioactive/relative dentin abrasion (RDA) and radioactive/relative enamel abrasion (REA) of dentifrices were also assessed. Methods: Specimens (n=10) of Tetric N Ceram Bulk Fill (TNCB), Filtek One Bulk Fill (FOB) resin composites, and Z100(Control) were prepared using a cylindrical Teflon matrix. Surface roughness (Ra, µm) was assessed by a roughness meter and the color evaluations (ΔEab , ΔE00 , WID ) were performed using a digital spectrophotometer based on the CIELAB system. Three measurements were performed per sample, before and after simulated toothbrushing with 3D Oral-B White Perfection (3DW) and Black is White (BW) dentifrices. The abrasivity (REA and RDA values) of the used dentifrices was also determined by the Hefferren abrasivity test. Results: The Ra values increased significantly in all resin composites after 3DW and BW toothbrushing. The acceptable threshold color varied among resin composites, and TNCB and Z100 presented the highest ΔEab and ΔE00 for BW dentifrice. The 3DW dentifrice was significantly more abrasive than BW dentifrice on enamel and dentin. Conclusions: simulated toothbrushing with tested whitening dentifrices increased the surface roughness at acceptable levels. The Tetric N Ceram Bulk-fill and Z100 composite showed the highest color alteration in BW. 3D White Perfection dentifrice was more abrasive on dentin and enamel than Black is White.

Reabilitação estética e funcional inferior com aumento de dimensão vertical de oclusão: relato de caso / Lower aesthetic and functional rehabilitation with increased vertical dimension of occlusion: case report

Os hábitos parafuncionais são caracterizados como movimentos involuntários e multifatoriais, podendo ter como principais fatores causais o estresse e a ansiedade. Essa condição acarreta, muitas vezes, na diminuição da dimensão vertical de oclusão por conta do desgaste dentário, prejudicando mastigação, fonação, estética e funções, sendo, portanto, de suma importância seu diagnóstico e tratamento. Aquele se dá através da anamnese, associado ao exame clínico e, se necessário, exames complementares. A abordagem clínico-terapêutica é ampla e multidisciplinar, devendo atuar no fator causal e suas consequências, existindo uma gama de possibilidades terapêuticas, tornando, por isso, um tratamento complexo. Por tal, o presente estudo aborda uma opção de tratamento em um relato de um caso clínico onde o paciente apresentava perda de dimensão vertical de oclusão, desgastes dentários e queixas funcionais e estéticas. A técnica se deu por meio do aumento da dimensão vertical através de Table Tops e facetas anteriores, ambas em resina composta atrelado ao aconselhamento multidisciplinar. Este trabalho mostrou a importância da realização de uma técnica reabilitadora correta, pois a sobrecarga e a perda de dimensão vertical podem gerar danos ao sistema estomatognático, prejudicando a articulação temporomandibular, ligamentos, músculos e dentes. Nesse contexto, conclui-se que é de suma importância uma avaliação minuciosa do paciente, tendo um planejamento correto do caso para um correto tratamento e um prognóstico positivo(AU)

Parafunctional habits are characterized as involuntary and multifactorial movements, and the main causal factors may be stress and anxiety. This condition often leads to a decrease in the vertical dimension of occlusion due to tooth wear, impairing chewing, phonation, aesthetics and functions, and therefore its diagnosis and treatment are of supreme importance. The former takes place through anamnesis, associated with a clinical examination and, if necessary, additional tests. The clinicaltherapeutic approach is wide and multidisciplinary and must operate on the causal factor and its consequences, with a range of therapeutic possibilities, turning it a complex treatment. Therefore, the study presents a treatment of a case report where the patient had loss of vertical dimension of occlusion, dental wear and functional and aesthetic complaints. The technique was performed by increasing the vertical dimension through Table Tops and anterior veneers, both in composite resin attached to a multidisciplinary advice. This work showed the importance of performing a correct rehabilitation technique, because the overload and loss of vertical dimension can cause damage to the stomatognathic system, harming the temporomandibular joint, ligaments, muscles and teeth. In this context, it is concluded that a thorough evaluation of the patient is very important, having a correct planning of the case for a correct treatment and a positive prognosis(AU)

Injectable Composite Resin Technique: An Alternative for Anterior Esthetic Restorations - Case Report / Técnica de Resina Compuesta Inyectable: Una Alternativa para Restauraciones Estéticas Anteriores - Reporte de Caso

This article aims to describe a clinical case of the use of the injectable restorative technique with composite resin in a patient with an esthetic complaint in the anterior teeth. Producing direct restorations in anterior teeth when performed with composite resin demands a long clinical time. Results often depend on the operator's ability to reproduce proper form, function, and esthetics. Lately, the versatility of composite resins has increased. As this material evolved, new techniques were introduced to simplify the restorative process and save time. The restorative technique with injectable fluid composite resin, in addition to delivering faster and with a certain ease, is capable of increasing the predictability of treatment results. However, it is known that flowable resins have lower wear resistance and color stability compared to conventional resins. Thus, a version of this material with a higher filler content in its composition was introduced to the market, to improve wear resistance and gloss retention. Long-term studies evaluating the use of low-viscosity resins are needed. The injectable technique can accurately reproduce the morphology obtained in the wax-up of the case, generating a satisfactory esthetic and functional result. Despite simplifying the fabrication of restorations when compared to the conventional technique, it is still necessary for the operator to have some experience and aptitude. The clinical time for the production of restorations has been considerably reduced. The material showed good flow, shine, and polish in the immediate result. However, the finishing and polishing of the restorations required a longer clinical period than usual and in the short- term follow-up, flaws in the gingival margins and a new finishing and polishing procedure were necessary. Therefore, the technique described in this article can be considered a restorative alternative, but it is still not able to replace the tradit ional method of making previous esthetic restorations.

Este artículo tiene como objetivo describir un caso clínico del uso de la técnica restauradora inyectable con resina compuesta en un paciente con una queja estética en los dientes anteriores. Producir restauraciones directas en dientes anteriores cuando se realizan con resina compuesta demanda un largo tiempo clínico. Los resultados a menudo dependen de la capacidad del operador para reproducir la forma, la función y la estética adecuadas. Últimamente, la versatilidad de las resinas compuestas ha aumentado. A medida que este material evolucionó, se introdujeron nuevas técnicas para simplificar el proceso de restauración y ahorrar tiempo. La técnica restauradora con resina compuesta fluida inyectable, además de una entrega más rápida y segura, es capaz de aumentar la previsibilidad de los resultados del tratamiento. Sin embargo, se sabe que las resinas fluidas tienen menor resistencia al desgaste y estabilidad del color en comparación con las resinas convencionales. Así, se introdujo en el mercado una versión de este material con un mayor contenido de relleno en su composición, con el objetivo de mejorar la resistencia al desgaste y la retención del brillo. Se necesitan estudios a largo plazo que evalúen el uso de resinas de baja viscosidad. La técnica inyectable es capaz de reproducir fielmente la morfología obtenida en el encerado del caso, generando un resultado estético y funcional satisfactorio. A pesar de simplificar la fabricación de restauraciones en comparación con la técnica convencional, todavía es necesario que el operador tenga cierta experiencia y aptitud. El tiempo clínico para la producción de restauraciones se ha reducido considerablemente. El material mostró buena fluidez, brillo y pulido en el resultado inmediato. Sin embargo, el acabado y pulido de las restauraciones requirió de un período de tiempo clínico más largo de lo habitual y en el seguimiento a corto plazo, fueron necesarios defectos en los márgenes gingivales y un nuevo procedimiento de acabado y pulido. Por lo tanto, la técnica descrita en este artículo puede considerarse una alternativa restauradora, pero aún no es capaz de reemplazar el método tradicional de realizar restauraciones estéticas previas.

Rendimiento Clínico de las Restauraciones Adhesivas con Resina Compuesta en Casos de Pacientes con Desgaste Severo e Incremento de Dimensión Vertical: Revisión de Literatura Sistematizada / Clínical Performance of Adhesive Restorations with Composite Resin in Cases of Patients with Severe Wear and Increased Vertical Dimension: Systematized Literature Review

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.

Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.

Restauração transcirúrgica: inter-relação periodontia e dentística / Transsurgical restoration: interrelationship between periodontics and dentistry

Tendo em vista a importância da relação Dentística Restauradora e Periodontia na Odontologia atual, o presente estudo demonstrou o relato de um caso clínico realizado no Complexo Odontológico do Centro Universitário da Serra Gaúcha (FSG), retratando um procedimento de restauração transcirúrgica em um paciente cujo elemento 13 estava comprometido com uma cavidade subgengival disto-palatino, sendo a resina composta o material restaurador de escolha. Este estudo teve como objetivo apresentar um caso clínico demonstrando a técnica de restauração transcirúrgica e a integração do planejamento entre Periodontia e Dentística Restauradora realizado na Clínica de Odontologia do Centro Universitário da Serra Gaúcha -FSG. Este trabalho mostrou a importância da realização de uma técnica cirúrgica e restauradora correta por parte dos cirurgiões-dentistas, assim como na verificação de que os tecidos periodontais podem reagir de forma positiva à presença de materiais restauradores adesivos posicionados subgengivalmente(AU)

In view of the importance of the restorative dentistry and periodontics relationship in current dentistry, the present study demonstrated the report of a clinical case carried out in the Dental Complex of the Centro Universitário da Serra Gaúcha - FSG, portraying a transsurgical restoration procedure in a patient whose element 13 was compromised with a subgingival cavity of this-palatine, the composite resin being the restorative material of choice. This study aimed to present a clinical case demonstrating the technique of transsurgical restoration and the integration of planning between Periodontics and Restorative Dentistry carried out at the Dentistry Clinic of the University Centro Universitário da Serra Gaúcha - FSG. This study showed the importance of performing a correct surgical and restorative technique by dentists, as well as in verifying that periodontal tissues can react positively to the presence of adhesive restorative materials positioned subgingival(AU)