Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Are Universal Adhesives Effective for Bonding to Zirconia in the Long Term?

Background: The bond capacity of universal adhesives should be comparable to a specific primer for zirconia. Thus, this study evaluated the bond strength to zirconia of four universal adhesives and a zirconia primer over long-term storage. Materials and Methods: The surfaces of 75 samples of zirconia were sandblasted with 50 µm aluminum oxide particles and then divided into groups (n = 15): G1 - Single Bond Universal (SBU); G2 - All Bond Universal; G3 - Peak Universal Bond; G4 - Ambar Universal (AU), and G5 - Z-Prime Plus (ZP). A cone of resin composite was constructed on the applied materials. The samples were submitted to a tensile bond strength test after 24 h using a universal testing machine. Then, the remaining materials were removed from the sample surfaces, and the surfaces were polished and sandblasted again as previously described to obtain the same groups. These new samples were stored in distilled water at 37°C for 12 months and then submitted to a tensile bond strength test. The data were analyzed by two-way analysis of variance and Tukey's test (α =0.05). Results: The material factor (P = 0.001) and the storage factor (P = 0.001) were significant, and the interaction was not significant (P = 0.117). According to Tukey's test, bond strength mean values (in MPa) followed by distinct letters were significantly different. After 24 h, G5 = 21.12 A, G1 = 20.55 A, G4 = 19.19 AB, G2 = 14.22 B, and G3 = 8.44 C. After 12 months, G1 = 7.37 A, G5 = 5.61 AB, G4 = 4.97 B, G2 = 3.32 C, and G3 = 1.93 D. After 12 months of storage, all groups' bond strength significantly decreased. Conclusions: SBU and AU had bond strengths comparable to ZP after 24 h. No material resisted water degradation.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins.

The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins

Abstract The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Resumo O objetivo deste estudo in vitro foi avaliar o efeito do ácido gástrico na rugosidade superficial e na formação do biofilme nas resinas compostas de incremento único. Vinte e sete amostras de cada resina composta foram confeccionadas: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). As amostras foram analisadas quantitativamente quanto à rugosidade da superfície (Ra) usando um rugosímetro (n=15) e para formação de biofilme (Cn) pela contagem de unidades formadoras de colônias (UFC/mL) (n=9) em três diferentes momentos: após polimento (Ra0 and Cn0), após imersão em ácido gástrico (Ra1 and Cn1), e após ácido gástrico e simulação de escovação (Ra2 and Cn2). Análise qualitative da topografia superficial (n=3) foi avaliada por meio de microscopia eletrônica de varredura (MEV). Os valores de Ra foram analisados pela ANOVA de duas vias para amostras pareadas, seguido do teste de Tukey. Os valores de Cn foram submetidos ao teste de Kruskal-Wallis, seguido da análise de comparações múltiplas (α=0,05). Z250 e FTK tiveram aumento significativo na rugosidade superficial em Ra1. Houve menos CFUs/mL para TTC e AUR em relação à Z250 e FTK em Cn0, Cn1 and Cn2. As imagens em MEV mostraram que o ácido gástrico aumentou a formação de fendas, exposição das partículas e mcrocavidades para todas as resinas compostas. Após escovação, as mudanças topográficas foram mais evidentes, mas não influenciou na formação do biofilme. O ácido gástrico promoveu degradação da superfície e adesão bacteriana para todas as resinas compostas.

Effect of Cariogenic Challenge on the Degradation of Adhesive-Dentin Interfaces.

The aim was to evaluate, in vitro, the influence of pH cycling on microtensile bond strength (µTBS) and percentage of nanoleakage (%NL) in the dentin-adhesive interface. Flat dentin surfaces were obtained in 56 extracted third molars. The teeth were randomly divided into four groups (n=14): G1- Single Bond Universal (etch-and-rinse mode); G2- Single Bond Universal (self-etch mode); G3- Scotchbond Multi-Purpose; G4- Clearfil SE Bond. A block of composite was built on the adhesive area. Eight tooth/resin sets were cut parallel to the tooth's long axis to obtain 48 beams (0.8 mm2) for each group. Half of the beams were submitted to four cycles of pH cycling (demineralizing solution for 6 h and remineralizing solution for 18 h). The samples were submitted to µTBS test in a universal testing machine. Six tooth/resin sets were cut parallel to the tooth's long axis to obtain three slices of the central region (1.0 mm thickness). Half of the slices were submitted to pH cycling. The nanoleakage methodology was applied to obtain the %NL at the adhesive interfaces. According to two-way ANOVA, the interaction between factors (adhesive system x storage) was significant (p=0.0001) for µTBS and %NL. After pH cycling, there was a significant decrease in µTBS and a significant increase in %NL for all adhesives. The adhesives applied in the self-etch mode obtained lower %NL, differing significantly from the etch-and-rinse adhesives. It was concluded that the pH cycling negatively influenced the µTBS and %NL for all adhesives evaluated. However, self-etch adhesives allowed less %NL.

Effect of cariogenic challenge on the degradation of adhesive-dentin interfaces

Abstract The aim was to evaluate, in vitro, the influence of pH cycling on microtensile bond strength (µTBS) and percentage of nanoleakage (%NL) in the dentin-adhesive interface. Flat dentin surfaces were obtained in 56 extracted third molars. The teeth were randomly divided into four groups (n=14): G1- Single Bond Universal (etch-and-rinse mode); G2- Single Bond Universal (self-etch mode); G3- Scotchbond Multi-Purpose; G4- Clearfil SE Bond. A block of composite was built on the adhesive area. Eight tooth/resin sets were cut parallel to the tooth's long axis to obtain 48 beams (0.8 mm2) for each group. Half of the beams were submitted to four cycles of pH cycling (demineralizing solution for 6 h and remineralizing solution for 18 h). The samples were submitted to µTBS test in a universal testing machine. Six tooth/resin sets were cut parallel to the tooth's long axis to obtain three slices of the central region (1.0 mm thickness). Half of the slices were submitted to pH cycling. The nanoleakage methodology was applied to obtain the %NL at the adhesive interfaces. According to two-way ANOVA, the interaction between factors (adhesive system x storage) was significant (p=0.0001) for µTBS and %NL. After pH cycling, there was a significant decrease in µTBS and a significant increase in %NL for all adhesives. The adhesives applied in the self-etch mode obtained lower %NL, differing significantly from the etch-and-rinse adhesives. It was concluded that the pH cycling negatively influenced the µTBS and %NL for all adhesives evaluated. However, self-etch adhesives allowed less %NL.

Resumo O objetivo foi avaliar, in vitro, a influência da ciclagem de pH na resistência de união à microtração (RUµT) e na porcentagem de nanoinfiltração (%NI) na interface dentina-adesivo. Superfícies planas em dentina foram obtidas em 56 terceiros molares. Os dentes foram aleatoriamente divididos em quatro grupos (n=14): G1- Single Bond Universal (condicionamento ácido prévio); G2- Single Bond Universal (autocondicionante); G3- Scotchbond Multi-Purpose; G4- Clearfil SE Bond. Bloco de resina composta foi construído sobre o adesivo. Oito conjuntos dente/resina foram cortados paralelamente ao longo eixo do dente para obter 48 palitos (0,8 mm2) para cada grupo. Metade dos palitos foi submetida a quatro ciclos de ciclagem de pH (solução desmineralizadora por 6 h e solução remineralizadora por 18 h). As amostras foram submetidas ao teste de RUµT em máquina de ensaio universal. Seis conjuntos dente/resina foram cortados paralelamente ao longo eixo para obter três fatias da região central (1,0 mm de espessura). Metade das fatias foi submetida à ciclagem de pH. A metodologia de nanoinfitração foi aplicada para obter a %NI nas interfaces. De acordo com ANOVA de duas vias, interação entre os fatores (adesivo x armazenamento) foi significativa (p=0.0001) para for RUµT e %NI. Após ciclagem de pH, houve redução significativa na RUµT e aumento significativo na %NI para todos adesivos. Os adesivos aplicados na técnica autocondicionante obtiveram menor %NI, diferindo significativamente dos adesivos com condicionamento ácido prévio. Concluiu-se que a ciclagem de pH influenciou negativamente a RUµT e a %NI para todos adesivos. Contudo, adesivos autocondicionantes permitiram menor %NI.

Surface roughness of monolithic zirconia ceramic submitted to different polishing systems

Aim: The objective was to evaluate, quantitative and qualitative, the abrasive effect of three polishing systems on the monolithic zirconia ceramic. Methods: Thirty disk-shaped samples of Yttria Tetragonal Zirconia Polycrystal (Y-TZP) were randomly distributed in three groups (n = 10) according to polishing system: G1- Komet system (KO); G2 - CeraGloss system (CG); G3 - Eve Diacera system (EV). The surface roughness (Ra) was obtained with Rugosimeter in four different moments: a) initial - glaze sample (Ra0); b) after occlusal adjustment with diamond burs (Ra1); c) after polishing with the abrasive systems (Ra2); d) after polishing with felt disc and diamond paste (Ra3). Four additional samples were observed in scanning electron microscopy (SEM). Results: According to the Generalized Estimating Equation followed by the Bonferroni test (α = 0.05), the CG provided the lowest Ra2 (0.63 µm), not differing significantly from the KO (0.78 µm). The highest Ra2 was obtained with the EV (0.97 µm), which did not differ significantly from the KO. There was no statistical difference in Ra between the polishing with the abrasive systems (Ra2) and the final polishing with diamond paste (Ra3). SEM images showed that the polishing systems did not completely remove the grooves caused by the diamond burs during the occlusal adjustment. Conclusion: It was concluded that CG promoted smoother surface of the monolithic zirconia ceramic compared to EV, and intermediate smoothness was obtained with KO

Aesthetic Rehabilitation in Teeth with Wear from Bruxism and Acid Erosion.

BACKGROUND: Bruxism is defined as a repetitive activity of grinding the teeth through lateral or protrusive movements of the mandible, and it is considered the most complex and destructive functional disorder. In addition, erosion caused by diet or reflux can damage the remaining teeth. OBJECTIVE: In this report, a patient with bruxism and dental erosion was treated with a multidisciplinary approach to restore the function and aesthetic. METHODS: This clinical report describes the management of an adult woman, 33 years old, who was dissatisfied with the aesthetics of her smile and complained of joint pain and headaches. As result of her condition, the patient's dentition exhibited generalized wear on the vestibular and incisal surface of the upper incisors incompatible with her age, moderate darkening of the teeth and excess gingival tissue in the upper incisors. After a detailed anamnesis and clinical examination, a diagnosis of bruxism and acid erosion caused by a diet rich in citrus foods and beverages was obtained. Forthwith, a treatment plan was established, and the patient underwent home bleaching, gingivoplasty and ceramic laminates of lithium disilicate on the anterior teeth. After the rehabilitation was completed, a night guard was made to reduce the symptoms of bruxism and avoid fracture of the ceramic restorations. The patient was followed at different time intervals. CONCLUSION: The improvement in the aesthetics of the teeth was significant and remained stable after periodic controls in which no adverse effects were observed.

Bond Capability of Universal Adhesive Systems to Dentin in Self-etch Mode after Short-term Storage and Cyclic Loading.

OBJECTIVE: The aim was to evaluate, in vitro, the tensile bond strength to dentin of Scotchbond Universal (SU), All-Bond Universal (AU) and One Coat 7 Universal (OC7) adhesives applied in self-etch mode, after 24 h of storage and after 500,000 loading cycles, using Clearfil SE Bond (SE) as a control. MATERIALS AND METHODS: The adhesives were applied on the dentin of bovine teeth, followed by the application of a composite resin. Thirty specimens were obtained for each adhesive. Half of the specimens were submitted to cyclic loading for 500,000 cycles. All specimens were submitted to a tensile bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/minute. RESULTS: According to two-way ANOVA and Tukey's test (α=5%), the interaction between the adhesive and cyclic loading factors was significant (p=0.001). The means followed by the same letter represent no significant difference in the bond strength (MPa) after 24 h: OC7=7.86A (±2.90), SU=6.78AB (±2.03), AU=5.61BC (±2.32), and SE=3.53C (±1.89). After cyclic loading, SE, SU and AU maintained bond strength comparable to 24 h period. There was a significant decrease only for OC7. CONCLUSION: SU, AU and OC7 had bond strength to dentin comparable to that of SE. Only OC7 had decreased bond strength to dentin after cyclic loading.

Bond Strength of a Novel One Bottle Multi-mode Adhesive to Human Dentin After Six Months of Storage.

OBJECTIVE: The aim of the study was to evaluate the microtensile bond strength (µTBS) of Scotchbond Universal to dentin using the etch-and-rinse or the self-etch technique after 24 h and 6 months of storage. MATERIALS AND METHODS: Flat dentin surfaces were obtained in 24 third molars. The teeth were divided into four groups: G1 - Scotchbond Universal applied in the etch-and-rinse mode; G2 - Scotchbond Universal applied in the self-etch mode; G3 - Scotchbond Multi-Purpose; G4 - Clearfil SE Bond. A block of composite was built on the adhesive area. The tooth/resin sets were cut parallel to the long axis to obtain 40 beams (~0.8 mm(2)) for each group. Twenty specimens were immediately submitted to the µTBS test, and the remaining 20 were stored in water for 6 months. Failures and the adhesive interface were analyzed by SEM. RESULTS: According to two-way ANOVA, the interaction between adhesive and storage time was significant (p=0.015).The µTBS (MPa) means were the following: 24 h - G1 (39.37±10.82), G2 (31.02±13.76), G3 (35.09±14.03) and G4 (35.84±11.06); 6 months - G1 (36.99±8.78), G2 (40.58±8.07), G3 (32.44±6.07) and G4 (41.75±8.25). Most failures were mixed. Evidence of hybrid layer and numerous resin tags were noted for Scotchbond Universal applied with the etch-and-rinse mode and Scotchbond Multi-Purpose. A thinner hybrid layer and fewer resin tags were noted for Scotchbond Universal applied in the self-etch mode and Clearfil SE Bond. CONCLUSION: The results indicate that the µTBS for Scotchbond Universal is comparable to the gold-standard adhesives. Scotchbond Universal applied in the self-etch mode and Clearfil SE Bond revealed higher bond stability compared to the etch-and-rinse mode.